Staging and grading of cervical cancer

Staging Back to top

Cervical cancer is divided into 4 main stages. Each stage then has further sub-divisions:

Stage 1

The cancer cells are only within the cervix.

• Stage 1A The cancer can only be seen with a microscope or colposcope.
• Stage 1A1 The cancer is 3 mm or less deep and 7mm or less wide.
• Stage 1A2 The cancer is between 3–5mm deep and 7mm or less wide.
• Stage 1B The cancer growth is larger but still confined to the cervix.
• Stage 1B1 The cancer is not larger than 4 cm.
• Stage 1B2 The cancer is larger than 4 cm.

Stage 2

The cancer has spread into surrounding structures such as the upper part of the vagina or tissues next to the cervix.

• Stage 2A The cancer has spread into the upper part of the vagina.
• Stage 2A1 The tumour size is not larger than 4cm.
• Stage 2A2 The tumour size is larger than 4cm.
• Stage 2B The cancer has spread into the tissues next to the cervix.

Stage 3

The cancer has spread to areas such as the lower part of the vagina, or tissues at the sides of the pelvic area.

• Stage 3A The cancer has spread into the lower part of the vagina.
• Stage 3B The cancer has spread through to the tissues at the sides of the pelvic area and may press on one of the ureters (the tubes through which the urine passes from the kidneys to the bladder). If the tumour is causing pressure on a ureter there may be a build up of urine in the kidney.

Stage 4

The cancer has spread to the bladder or bowel or beyond the pelvic area.

• Stage 4A The cancer has spread to nearby organs such as the bladder and bowel.
• Stage 4B The cancer has spread to more distant organs such as the lungs, liver or bone.

If the cancer comes back after initial treatment this is known as recurrent cancer .

When staging the cancer, your specialists may also look at whether it has spread to any of the lymph nodes. This is important because sometimes it’s possible for cancer cells to travel to other parts of the body through the lymphatic system, causing a secondary cancer.

Checking if the cancer is in any of the lymph nodes near the cervix is an important part of the staging process as it helps your doctors plan the best treatment for you..

Grading Back to top

The grade of a cancer gives an idea of how quickly it may develop. To find the grade of your cancer, your doctors will look at a sample of the cancer (a biopsy) under the microscope. It may be graded as:

• Grade 1 (low grade) – the cancer cells tend to be slow growing, look quite similar to normal cells (are 'well differentiated') and are less likely to spread than higher grades.
• Grade 2 (moderate grade) – the cells look more abnormal and are slightly faster-growing.
• Grade 3 (high grade) – the cancer cells tend to be more quickly growing, look very abnormal (are 'poorly differentiated') and are more likely to spread than low-grade cancers.