Stages of cervical cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests and exams is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for cervical cancer is the FIGO system. For cervical cancer there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

Stage 0 is not included in the FIGO system. Stage 0 is a precancerous condition of the cervix that is also called carcinoma in situ.

When describing the stage, doctors may use the words local, regional or distant. Local means that the cancer is only in the cervix and has not spread to other parts of the body. Regional means close to the cervix or around it, like the vagina or pelvis. Distant means in a part of the body farther from the cervix and outside of the pelvis.

Some doctors may also use the following terms when discussing cervical cancer:

• Early stage cervical cancer usually includes stages 1A, 1B and 2A.
• Locally advanced cervical cancer usually includes stages 2B, 3 and 4A.
• Advanced stage cervical cancer usually means stage 4B.

Find out more about staging cancer.

The tumour is in the cervix and can only be seen with a microscope. The tumour is not more than 5 mm deep and not more than 7 mm wide.

Stage 1A1 – The tumour is not more than 3 mm deep and not more than 7 mm wide.

Stage 1A2 – The tumour is more than 3 mm, but not more than 5 mm deep and not more than 7 mm wide.

The tumour is in the cervix and can be seen without a microscope or the tumour can only be seen with a microscope but is bigger than a stage 1A tumour.

Stage 1B1 – The tumour is more than 5 mm but not more than 2 cm at its widest part.

Stage 1B2 – The tumour is more than 2 cm but not more than 4 cm at its widest part.

Stage 1B3 – The tumour is more than 4 cm at its widest part.

The tumour has grown outside of the cervix and the uterus but hasn’t grown into the walls of the pelvis or to the lower part of the vagina. It also hasn’t grown into tissues next to the cervix and uterus (called the parametria).

Stage 2A1 – The tumour is less than 4 cm at its widest part.

Stage 2A2 – The tumour is more than 4 cm at its widest part.

The tumour has grown outside of the cervix and the uterus into tissues next to the cervix and uterus. The tumour hasn’t grown into the walls of the pelvis or to the lower part of the vagina.

The tumour has grown into the lower part of the vagina but not into the walls of the pelvis.

The tumour has grown into the walls of the pelvis, blocks a ureter (the tube that carries urine from the kidney to the bladder) causing an enlarged kidney (hydronephrosis) or stops the kidney from working.

OR

The cancer has spread to lymph nodes in the pelvis.

The tumour has grown into the bladder, rectum or outside of the pelvis.

The cancer has spread to other parts of the body (called distant metastasis), such as to lymph nodes outside of the pelvis or to the lungs, liver or bone. This is also called metastatic cervical cancer.

Recurrent cervical cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to where it first started, it’s called regional recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.