Get the Facts About Gynecologic Cancer

Get the Facts About Gynecologic Cancer

Cervical Ovarian Uterine Vaginal Vulvar

U.S. Department of 

Health and Human Services

Centers for Disease 

Control and Prevention

www.cdc.gov/cancer/knowledge

1-800-CDC-INFO
About This Booklet

This booklet was developed in support of the Centers for Disease Control and Prevention’s (CDC) Inside 

Knowledge: Get the Facts About Gynecologic Cancer campaign. The campaign helps women get the facts 

about gynecologic cancer by providing important “inside knowledge” about their bodies and health. 

As you read this booklet, you will learn about the different types of gynecologic cancer. These are cancers 

that affect the female reproductive organs. They include cervical, ovarian, uterine, vaginal, and vulvar 

cancers. You will find information on:

• Signs, symptoms, and risk factors related to each gynecologic cancer.

• What you can do to help prevent gynecologic cancer. 

• What to do if you have symptoms. 

• What to do if you think you may be at increased risk for developing a gynecologic cancer. 

• Questions to ask your doctor.

Each year, approximately 71,500 women in the United States are diagnosed with a gynecologic cancer. 

While all women are at risk for developing gynecologic cancers, few will ever develop one. Still, it is 

important to know the signs because there is no way to know for sure who will get a gynecologic cancer. 

The information included in this booklet will help you recognize any warning signs, so you can ask your health 

care provider about them. These signs and symptoms often are related to something other than gynecologic 

cancer. But it is important for your overall health to know what is causing them.

Important words to know appear in italics and are included with definitions in the glossary at the 

back of the booklet. 
Table of Contents

2 Gynecologic cancer overview

6 Gynecologic cancer symptoms

7 Questions to ask your doctor

8 Cervical cancer

12 Ovarian cancer

16 Uterine cancer

18 Vaginal cancer

20 Vulvar cancer

22 Gynecologic cancer diagnosis

24 Resources

26 Glossary 

The Inside Knowledge: Get the Facts About

Gynecologic Cancer campaign is an initiative that 

supports the Gynecologic Cancer Education and 

Awareness Act of 2005, or Johanna’s Law, which 

was unanimously passed by the 109th Congress 

in 2006, and signed into law in January 2007.

To find out more: 

Visit www.cdc.gov/cancer/knowledge 

Call 1-800-CDC-INFO

1
Gynecologic Cancer Overview

What is cancer?

Cancer is a group of diseases in which abnormal cells in the body divide and grow out of 

control. These abnormal cells can spread to other parts of the body. When this happens, it is 

called metastasis. There are more than 100 different types of cancer. Cancer is usually named 

for the organ or part of the body where it starts, or the type of cell in which it starts, even if it 

spreads to other body parts later. For example, cancer that begins in the ovaries and spreads 

to another organ is still called ovarian cancer, even after it has spread. Treatment can be most 

effective when cancer is found at an early stage. 

2
What causes cancer? 

In most cases, the exact cause of cancer 

is not known. However, it is clear that 

certain changes in cells can cause cancer. 

These cell changes can be acquired or 

inherited. If the changes are acquired, 

they are caused by environmental factors 

and things people do, such as smoking. 

Almost all cervical cancers and some 

vaginal and vulvar cancers are caused 

by human papillomavirus, also called 

HPV, which is an acquired virus. However, 

if the changes are inherited, they are passed 

from parent to child through genes. 

What is gynecologic cancer?

Gynecologic cancer is any cancer that 

starts in a woman’s reproductive organs. 

While they are often discussed as a group, 

each gynecologic cancer is unique. Each 

has different signs, symptoms, and risk 

factors (things that may increase your 

chance of getting each cancer). For some 

of these cancers, there are ways to lower 

your risk. 

The five main types of gynecologic 

cancer are: 

• Cervical cancer: Begins in the cervix, 

the lower part of the uterus (or womb). 

• Ovarian cancer: Begins in the ovaries, 

located on each side of the uterus. 

• Uterine cancer: Begins in the uterus, 

the pear-shaped organ in a woman’s 

pelvis where the baby grows when a 

woman is pregnant. 

• Vaginal cancer: Begins in the vagina, 

the hollow, tube-like channel between the 

bottom of the uterus and the outside of 

the body. It is also called the birth canal. 

• Vulvar cancer: Begins in the vulva, the 

outer part of the female genital organs, 

which includes the inner and outer lips of 

the vagina, the clitoris, and the opening 

of the vagina and its glands. 

Additional types of gynecologic cancer 

exist, and include fallopian tube cancer and 

primary peritoneal cancer. (Please see p. 13 

for more information.) 

Who gets gynecologic cancer?

While all women are at risk for gynecologic 

cancer, this risk generally increases with age.

Each year in the United States, approximately 

71,500 women are diagnosed with 

gynecologic cancer and approximately 

26,500 women die from it. 

3
What increases a woman’s risk of 

getting gynecologic cancer?

There is no way to know which women will 

get gynecologic cancer. Each specific type 

of gynecologic cancer has a unique set of 

risk factors. These are discussed in detail 

for each cancer on the pages that follow.

Human papillomavirus (HPV) infections that 

do not go away increase the risk of getting 

several types of gynecologic cancers. HPV is 

a common sexually transmitted virus that can 

cause cervical, vaginal, and vulvar cancers. It 

is one of the most well-established risk factors 

for these three cancers.

For more information about your risk, talk 

to your doctor, nurse, or other health care 

professional*. 

* Please note that throughout the brochure the word 

“doctor” will be used to refer to doctors, nurses, and 

other health care professionals.

Who gets HPV?

HPV is a common virus with more 

than 100 different kinds or types. 

More than 30 of the types can be 

passed from one person to another 

during sex. HPV can occur in both 

men and women. At least half of all 

sexually active people will get HPV 

at some point in their lives.

Any woman who has ever had sex is 

at risk for getting HPV. Women are 

more likely to have HPV if they started 

having sex at an early age and if they 

or their partner have had sex with 

several others. 

Condoms can lower your chance of 

getting HPV, if they are used all the 

time and the right way. However, HPV 

can infect areas that are not covered 

by a condom, so condoms do not fully 

protect against HPV.

How does HPV cause cancer?

Most of the time, people who become 

infected with HPV will not have any 

symptoms and the infection will clear up 

on its own. However, when the infection 

does not clear up, it can cause normal 

cells to turn abnormal. Over time, these 

abnormal cells can turn into cancer of 

the cervix, vagina, or vulva.

How likely am I to get a 

gynecologic cancer if I have HPV?

Many people will have an HPV infection 

at some time in their lives, but few 

women will get cervical, vaginal, or 

vulvar cancer—the gynecologic cancers 

that are linked to HPV.

4
How can I help prevent 

gynecologic cancer or find it early?

While there is no known way to prevent 

all types of gynecologic cancer, there 

are things you can do that may help 

lower your chance of getting them or 

help to find them early. It is important 

to find gynecologic cancers early, when 

treatment can be most effective. 

• Pay attention to your body and 

know what is normal for you. If you 

have any abnormal vaginal bleeding, 

or if you have any other signs and 

symptoms of gynecologic cancer for 

two weeks or longer and they are not 

normal for you, talk to a doctor right 

away. The symptoms may be caused 

by something other than cancer, but 

the only way to know is to see a doctor.

• Make healthy lifestyle choices. For 

overall good health, eat a diet rich 

in fruits and vegetables; exercise 

regularly; maintain a healthy weight; 

avoid smoking; and practice safe sex. 

• Know your family health history. 

Share it with your doctor.

• Get the HPV vaccine, if you are at 

an age when it is recommended. 

It protects against the types of HPV 

that most often cause cervical, vaginal, 

and vulvar cancers. It is given in a 

series of three shots. The vaccine is 

recommended for 11- and 12-year-old 

girls. (Note: The vaccine can be given 

to girls beginning at age 9.) It also is 

recommended for girls and women 

aged 13 through 26 years who did 

not get any or all of the shots when 

they were younger. 

• Get regular Pap tests. Pap tests (or Pap 

smears) are one of the most reliable and 

effective cancer screening tests available. 

Pap tests can find precancerous changes 

on the cervix that can be treated so that 

cervical cancer is prevented. A Pap test 

can also find cervical cancer early, when 

treatment is most effective. The only cancer 

the Pap test screens for is cervical cancer.

• Get the HPV test, if it is recommended 

by your doctor. 

5

Pap test. The Pap test can find 

precancerous changes on the 

cervix that can be treated to prevent 

cervical cancer. A Pap test also 

can find cervical cancer early, when 

treatment is most effective. Current 

recommendations indicate that 

women should start getting regular 

Pap tests at age 21.

The Pap test does NOT screen for 

ovarian, uterine, vaginal, or vulvar 

cancers. Even if you have a Pap 

test regularly, see your doctor if you 

notice any signs or symptoms that 

are not normal for you. 

HPV test. The HPV test looks for 

HPV infection. This test may be 

used with the Pap test to screen 

for cervical cancer in women aged 

30 years and older. It also is used 

to provide more information when 

a Pap test has unclear results. If 

you have HPV, follow your doctor’s 

advice for further testing.

(For more information about both the 

Pap test and HPV test, see p. 10.)
Gynecologic Cancer Symptoms

What are the signs and symptoms of gynecologic cancer?

The signs and symptoms shown here are often related to gynecologic cancer. However, 

not all women with gynecologic cancer have the same symptoms. And sometimes 

symptoms are difficult to recognize because they may be caused by or related to other 

conditions. That is why it is important to pay attention to your body and know what is 

normal for you. 

Gynecologic Cancer Symptoms

6
7

Questions to 

Ask Your Doctor

When visiting a doctor, it may be helpful 

to bring a list of questions to ask and to 

take notes during your visit. Consider 

asking the following questions:

1) What is my risk for getting a 

gynecologic cancer, such as cervical, 

ovarian, uterine, vaginal, or vulvar cancer? 

2) When should I have my next Pap test? 

3) What do my Pap test results mean?

4) Is the HPV test right for me?

5) When can I stop getting a Pap test? 

6) Are there any other gynecologic 

cancer tests that I need, based on 

my personal health and family cancer 

history? If so, what are they? 

Why do I need them? How do 

they work?

7) I have noticed [insert any symptoms 

you are experiencing], which is not 

normal for me. Could this be caused 

by a gynecologic cancer? If so, what 

should I do next? 

Talk to a doctor right away if:

• You have any abnormal vaginal 

bleeding between periods, after sex, 

or after menopause.

• You have any of the other signs and 

symptoms of gynecologic cancer for two 

weeks or longer and they are not normal 

for you. 

The symptoms may be caused by something 

other than cancer, but the only way to know 

is to see a doctor.
Cervical Cancer

What is cervical cancer?

When cancer starts in the cervix, it is called cervical 

cancer. The cervix is the lower, narrow end of the 

uterus (or womb). The cervix connects the upper 

part of the uterus to the vagina (the birth canal).

Cervical cancer is the only gynecologic cancer

that can be prevented, by having screening tests 

routinely and following up, as necessary. It also is 

highly curable when found and treated early. 

8
9

Who gets cervical cancer?

All women who have a cervix are at risk for 

cervical cancer. Women who have had a total 

hysterectomy, which includes the removal of 

the cervix, are not at risk for cervical cancer. 

(If you are not sure if your cervix was removed 

during a hysterectomy, ask your doctor.) 

Cervical cancer occurs most often in 

women over the age of 30. Each year, 

approximately 12,000 women in the 

United States get cervical cancer. 

Cervical cancer is among the leading 

causes of death worldwide, and used 

to be the leading cause of cancer death for 

women in the United States. However, in 

the past 40 years, there has been a major 

decrease in the number of deaths from 

cervical cancer. This decline largely is due 

to many women getting regular Pap tests, 

which can find precancerous changes that 

can be treated before they turn into cancer.

What are the symptoms of 

cervical cancer?

Early on, cervical cancer may not cause 

signs and symptoms. In later stages, 

cervical cancer may cause bleeding—

especially after sex—or discharge from the 

vagina that is not normal for you. 

If you have unusual bleeding or discharge, 

see a doctor. The symptoms may be caused 

by something other than cervical cancer, but 

the only way to know is to see a doctor.

What raises a woman’s chance of 

getting cervical cancer?

Certain types of human papillomavirus (HPV) 

may lead to cervical cancer. Almost all cervical 

cancers are linked to HPV. (See Gynecologic 

Cancer Overview for more information about 

HPV.) However, there are other things that 

can increase your risk, including: 

•	 Smoking.

•	 Having HIV or another condition that 

makes it hard for your body to fight off 

health problems.

•	 Using birth control pills for a long time. 

•	 Having given birth to three or more children. 

• Exposure before birth (while in the womb) to 

Diethylstilbestrol (DES), which is a man-made 

form of estrogen prescribed until 1971 to 

help women with pregnancy complications.

How can I help lower my chance of 

getting cervical cancer?

There are several things you can do that may 

reduce your chance of getting cervical cancer.

1) Protect yourself from HPV. 

• Talk to your doctor about getting the HPV 

vaccine, which protects against the types 

of HPV that most often cause cervical, 

vaginal, and vulvar cancers.

•	 Use condoms during sex.

• Limit your number of sexual partners.

2) See a doctor regularly for a Pap test that 

looks for cervical precancers and cancer. Be 

sure to follow up with the doctor if your test 

results are not normal.

3) Don’t smoke. Smoking harms all of your 

body’s cells, including your cervical cells. If 

you smoke and have HPV, you have a higher 

chance of getting cervical cancer. If you 

smoke, ask a doctor for help quitting. 
Are there ways to prevent cervical 

cancer or find it early?

Yes. The Pap test, HPV test, and HPV 

vaccine all help to prevent cervical cancer.

1) The Pap test is one of the most reliable 

and effective screening tests available. 

Getting a Pap test regularly is important 

because it can find precancerous changes on 

the cervix that can be simply and effectively 

treated to prevent cervical cancer. A Pap 

test also can find cervical cancer early, when 

treatment is most effective. 

The only cancer the Pap test screens for is 

cervical cancer. It does not screen for any 

other type of cancer.

Most cervical cancers occur among women 

who have never had a Pap test or have not 

had one in the last five years.

2) The HPV test looks for HPV—the virus 

that can cause cell changes on the cervix. 

For women aged 30 years and older, the 

HPV test can be used along with the Pap 

test (called co-testing) to screen for cervical 

cancer. It also is used to provide more 

information when Pap test results for women 

aged 21 and older are unclear. 

3) Two HPV vaccines are available to protect 

females against the types of HPV that cause 

most cervical cancers, and vaginal and vulvar 

cancers. Both vaccines are recommended for 

11- and 12-year-old girls, and for females 13 

through 26 years of age who did not get any 

or all of the shots when they were younger. 

These vaccines also can be given to girls as 

young as 9 years of age. It is recommended 

that females get the same vaccine brand for all 

three doses, whenever possible. It is important 

to note that even women who are 

vaccinated against HPV need to have 

regular Pap tests to screen for cervical 

cancer. (The HPV vaccine is also 

recommended for boys and young men. 

To learn more, visit www.cdc.gov/hpv/

vaccine.html.)

When and how often should 

I get a Pap test?

All women should start getting regular Pap 

tests at age 21. How often you get a Pap 

test depends on many factors: 

•	 If your Pap test results are normal, your 

doctor may tell you that you will not 

need another Pap test for three years. 

•	 If you are 30 or older, you may choose 

to have an HPV test along with the 

Pap test. Both tests can be performed 

by your doctor at the same time. If 

the results are normal, your chance of 

getting cervical cancer in the next few 

years is very low. Your doctor may then 

tell you that you can wait up to five years 

for your next screening. 

For women aged 21-65, it is important 

to continue getting a Pap test as directed 

by your doctor—even if you think you are 

too old to have a child or are not having 

sex anymore. However, your doctor may 

tell you that you do not need to have a 

Pap test if either of these is true for you:

• You are older than 65 and have had 

normal Pap test results for several years.

• You have had your cervix removed as 

part of a total hysterectomy for noncancerous conditions, like fibroids.

10
What does my Pap test result mean?

Your Pap test result will come back as 

“normal,” “unclear,” or “abnormal.”

Normal: A normal (or “negative”) result 

means that no cell changes were found on 

your cervix. However, it is still important to 

get Pap tests regularly because new 

cell changes can develop.

Unclear: The doctor may use other words 

to describe this result, including equivocal, 

inconclusive, or ASC-US. These all mean 

the same thing: that your cervical cells look 

like they could be abnormal. It is not clear if 

this is related to HPV or to other life changes, 

like pregnancy, menopause, or some other 

infection. The HPV test can help find out if 

your cell changes are related to HPV.

Abnormal: An abnormal result means that 

cell changes were found on your cervix. But 

don’t be alarmed—this does not necessarily 

mean you have cervical cancer. Most of the 

time, minor changes go back to normal on 

their own. But more serious changes—

precancers—can turn into cancer if they 

are not treated. If your test is abnormal, it 

is very important to follow up with your 

doctor because you likely will need more 

tests or treatment.

Where can I find free or low-cost 

cervical cancer screening tests?

You may be able to get free or low-cost 

cervical cancer screening tests if you:

• Have health insurance. Contact your 

insurance provider to find out if cervical 

cancer screening is covered.

• Are eligible for Medicaid. To learn 

more, visit www.medicaid.gov.

• Are aged 65 years or older. Medicare 

pays for the Pap test every two years, 

or every year for some women. To learn 

more, call 1-800-MEDICARE or visit 

www.medicare.gov.

•	 Have a low income or do not have 

health insurance. CDC’s National 

Breast and Cervical Cancer Early 

Detection Program offers free or 

low-cost screening. To learn more, 

call 1-800-CDC-INFO or visit 

www.cdc.gov/cancer/nbccedp.

Where can I find free or low-cost 

HPV vaccines?

Girls through 18 years of age may be able 

to get the HPV vaccine for free or at lowcost. To learn more, call 1-800-CDC-INFO 

or visit www.cdc.gov/vaccines/programs/

vfc/parents/.

11
Ovarian Cancer

What is ovarian cancer?

When cancer starts in the ovaries, it is called ovarian cancer. 

Women have two ovaries that are located in the pelvis, 

one on each side of the uterus. The ovaries make female 

hormones and produce eggs. 

Who gets ovarian cancer?

All women are at risk for ovarian cancer, but older women are 

more likely to get the disease than younger women. About 

90 percent of women who get ovarian cancer are older 

than 40. The greatest number of ovarian cancers occurs in 

women aged 60 years or older. Women who have had both 

ovaries removed have a much lower risk of ovarian cancer. 

Each year, approximately 20,000 women in the United 

States get ovarian cancer.

12
13

What are the signs and symptoms 

of ovarian cancer?

Ovarian cancer may cause the following 

signs and symptoms: 

• Vaginal bleeding, such as irregular 

periods, bleeding that is heavier than 

normal for you, or that occurs when you 

are past menopause.

• Discharge from your vagina that is not 

normal for you.

• Pain or pressure in the pelvic or 

abdominal area.

• Back pain.

• Bloating or feeling full quickly 

while eating. 

• Change in bathroom habits, such as 

having to pass urine very often and 

with greater than usual urgency, 

constipation, or diarrhea.

Pay attention to your body and know what is 

normal for you. If you have unusual vaginal 

bleeding, see a doctor right away. If you have any 

of the other signs for two weeks or longer and they 

are not normal for you, see a doctor. They may 

be caused by something other than cancer, but 

the only way to know is to see a doctor. 

What raises a woman’s chance of 

getting ovarian cancer?

There is no way to know if you will get ovarian 

cancer. However, there are several factors 

that may increase the chance that you will get 

it, including if you: 

• Are middle-aged or older.

• Have close family members (such as your 

mother, sister, aunt, or grandmother) on 

either your mother’s or your father’s side, 

who have had ovarian cancer.

• Have had breast, uterine, or 

colorectal cancer.

• Have an Eastern European (Ashkenazi) 

Jewish background.

• Have never given birth or have had trouble 

getting pregnant.

• Have endometriosis.

•	 Have tested positive for a genetic 

abnormality called a BRCA1 or BRCA2.

In addition, some studies suggest that women 

who take estrogen by itself (estrogen without 

progesterone) for 10 or more years may have 

an increased risk of ovarian cancer.

If one or more of these is true for you, it does 

not mean you will get ovarian cancer. But you 

should talk to a doctor about your risk. 

There are two very rare types of 

gynecologic cancer that are similar 

to ovarian cancer:

Fallopian tube cancer starts 

in the fallopian tubes, the tubes 

where eggs pass from the ovaries 

to the uterus. 

Primary peritoneal cancer 

starts in the peritoneum, the tissue 

lining that covers the organs in 

the abdomen. 
How can I help prevent or 

lower my chance of getting 

ovarian cancer?

There is no known way to prevent 

ovarian cancer. But these things are 

associated with a lower chance of 

getting it:

• Having used birth control pills for more 

than five years.

• Having had a tubal ligation (getting 

your tubes tied), both ovaries removed, 

or a hysterectomy. 

• Having given birth.

Are there ways to find ovarian 

cancer early?

Currently there is no effective screening test 

for ovarian cancer, and it can be very hard 

to identify ovarian cancer early. The signs 

and symptoms of ovarian cancer are not 

always clear and may be hard to recognize. 

The Pap test does not screen for ovarian 

cancer. The only cancer the Pap test 

screens for is cervical cancer. That is why 

it is so important to pay attention to your 

body and know what is normal for you. If 

you notice any changes in your body that 

last for two weeks or longer and may be a 

sign or symptom of ovarian cancer, talk to a 

doctor and ask about possible causes.

14
Rectovaginal pelvic exams, transvaginal 

ultrasounds, and CA-125 blood tests can 

be used in combination to help diagnose 

ovarian cancer. Ask a doctor about these 

tests, if:

• You have any unexplained signs or 

symptoms of ovarian cancer that last 

for two or more weeks.

• You had breast, uterine, or 

colorectal cancer.

• A close relative had ovarian cancer or 

you tested positive for the BRCA1 or 

BRCA2 gene.

When ovarian cancer is found early, 

treatment can be most effective.

Should I have a genetic test for 

ovarian cancer?

If you or your family have a history of 

breast or ovarian cancer, your doctor 

may recommend genetic testing and 

counseling. Genetic testing is useful for 

a very small percentage of women who 

have a family history of cancer. It is not 

recommended for all women, but it is 

important for all women to know their 

family history. 

Genetic testing can help some women find 

out if they have an increased chance of 

developing breast and ovarian cancer. It 

works by finding changes or alterations in 

genes known as breast cancer susceptibility 

genes 1 and 2 (BRCA1 and BRCA2).

If you are considering genetic testing, you 

should get genetic counseling to help you 

decide whether to get tested, and to learn 

what the test results may mean for you. 

If the following is true for you, you may benefit 

from genetic counseling and testing:

You have an Eastern European (Ashkenazi) 

Jewish background, and on your mother’s or 

father’s side you have one of the following: 

• A first-degree relative (parent, sibling, or 

child) with breast or ovarian cancer.

• Two second-degree relatives (grandparent, 

grandchild, uncle, aunt, nephew, niece, or 

half-sibling) on the same side of the family 

with breast or ovarian cancer.

You do not have an Eastern European (Ashkenazi) 

Jewish background, but on your mother’s or 

father’s side you have one of the following:

• Two first-degree relatives (i.e., parent, sibling, 

or child) with breast cancer and at least one of 

them was diagnosed at or before the age of 50.

• A combination of three or more first- or 

second-degree relatives with breast cancer, 

regardless of the age they were when the 

cancer was diagnosed.

•	 A combination of breast and ovarian cancer

among first- and second-degree relatives.

• A first-degree relative with breast cancer in 

both breasts.

• A combination of two or more first- or 

second-degree relatives with ovarian 

cancer, regardless of the age they were 

when the cancer was diagnosed.

• A first- or second-degree relative with both 

breast and ovarian cancer, diagnosed at 

any age.

• A history of breast cancer in a male relative.

15
Uterine Cancer

16

What is uterine cancer?

When cancer starts in the uterus, it is called 

uterine cancer. The uterus is the pear-shaped 

organ in a woman’s pelvis. Also called the 

womb, the uterus is where the baby grows 

when a woman is pregnant.

Who gets uterine cancer?

All women—except those whose uterus was 

removed by having a hysterectomy—are at risk 

for uterine cancer, and the risk increases with 

age. Most uterine cancers are found in women 

who are going through or have gone through 

menopause. Each year, approximately 35,000 

women in the United States get uterine cancer.

What are the signs and symptoms 

of uterine cancer?

Signs and symptoms of uterine cancer include: 

•	 Vaginal discharge or bleeding that is not 

normal for you. The bleeding may be 

abnormal because of how heavy it is or when 

it happens, such as bleeding after you have 

gone through menopause; bleeding between 

periods; or any other bleeding that is longer 

or heavier than is normal for you. 

•	 Pain or pressure in your pelvis.

If you have bleeding that is not normal for 

you, especially bleeding after menopause, 

see a doctor right away. If you have pain or 

pressure in your pelvis or abnormal vaginal 

discharge for two weeks or longer, see a 

doctor. These things may be caused by 

something other than cancer, but the only 

way to know is to see a doctor.

There are two main types of 

uterine cancer:

Endometrial cancer: The most 

common type of uterine cancer. 

Endometrial cancer forms in the 

lining of the uterus, which is called 

the endometrium.

Uterine sarcoma: A rare type 

of uterine cancer that forms 

in the muscle or other tissue of 

the uterus.

When uterine cancer is found early, 

treatment is most effective.
17

What raises a woman’s chance of 

getting uterine cancer?

There is no way to know who will get uterine 

cancer. However, several factors may 

increase the chance that you will get uterine 

cancer, including if you:

• Are older than age 50.

•	 Are obese (having an abnormally high,

unhealthy amount of body fat). 

• Take estrogen by itself for hormone 

replacement during menopause. In 

general, when estrogen is used, it should 

be in combination with the other female 

hormone, progesterone. 

• Have had trouble getting pregnant, or 

have had fewer than five periods in a 

year at any time in your life before 

starting menopause.

•	 Take tamoxifen, a drug used to prevent 

or treat certain types of breast cancer.

If one or more of these is true for you, 

it does not mean you will get uterine 

cancer, but you should talk with a doctor 

to see if he or she recommends more 

frequent exams.

Women who have an inherited form 

of colorectal cancer, called hereditary 

nonpolyposis colorectal cancer syndrome, 

have an increased risk of getting uterine 

cancer. This may be true for you if you 

have close female relatives (i.e., your 

mother, grandmother, sister, aunt, or 

daughter) who have had uterine or ovarian 

cancer. If so, talk to a doctor about having 

annual exams and endometrial biopsies, 

starting at age 35.

How can I help prevent or lower my 

chance of getting uterine cancer?

There is no known way to prevent uterine 

cancer. But these things may reduce your 

chance of getting uterine cancer: 

• Using birth control pills.

• Maintaining a healthy weight and being 

physically active.

• Taking progesterone, if you are taking 

estrogen.

• Talking with a doctor about how often 

you should be checked for uterine 

cancer, especially if you think that you 

have factors that increase your chance 

of getting it.

Are there ways to find uterine 

cancer early?

There are no simple and reliable ways to 

test for uterine cancer in women who do not 

have any signs or symptoms. The Pap test 

does not screen for uterine cancer. The 

only cancer the Pap test screens for is 

cervical cancer. This is why it is important 

to know the signs and symptoms of uterine 

cancer and to see a doctor if you have any 

of them. 

If you have symptoms or are at a higher risk 

for uterine cancer, your doctor may perform 

an endometrial biopsy or a transvaginal 

ultrasound. These tests can be used to help 

diagnose or rule out uterine cancer. Your 

doctor may do this test in his or her office, or 

may refer you to another doctor. The doctor 

might perform more tests if the endometrial 

biopsy does not provide enough information, 

or if symptoms continue.
18

Vaginal Cancer

What is vaginal cancer?

When cancer starts in the vagina, it is 

called vaginal cancer. The vagina, also 

called the birth canal, is the hollow, tubelike channel between the bottom of the 

uterus and the outside of the body. 

When vaginal cancer is found early, 

treatment is most effective.

Who gets vaginal cancer?

While vaginal cancer is very rare, all women 

are at risk. Each year, approximately 

1,000 women in the United States get 

vaginal cancer.

What are the signs and symptoms 

of vaginal cancer?

Most vaginal cancers do not cause signs 

or symptoms early on. But if symptoms 

are present, they may include:

•	 Vaginal discharge or bleeding that 

is not normal for you. The bleeding 

may be abnormal because of how 

heavy it is, or when it happens, such 

as bleeding after you have gone 

through menopause; bleeding 

between periods; or any other bleeding 

that is longer or heavier than is normal 

for you. 

•	 Change in bathroom habits, including 

having blood in the stool or urine; going 

to the bathroom more often than usual; 

or feeling constipated.

•	 Pain in your pelvis or abdomen, 

especially when you pass urine or 

have sex.

If you have abnormal vaginal bleeding, 

see a doctor right away. If you have any 

of the other signs for two weeks or longer, 

see a doctor. They may be caused by 

something other than cancer, but the only 

way to know is to see a doctor.

What raises a woman’s chance 

of getting vaginal cancer?

There is no way to know for sure who 

will get vaginal cancer. However, these 

things may increase the chance you will 

get it: 

• Having HPV.

• Having a history of abnormal Pap test

results showing abnormal cervical cells 

or having had cervical cancer.

•	 Having HIV or another condition that 

makes it hard for your body to fight off 

health problems.
• Exposure before birth (while in the womb) 

to Diethylstilbestrol (DES), which is a 

man-made form of estrogen that was 

prescribed until 1971 to help women with 

pregnancy complications.

•	 Smoking.

If one or more of these is true for you, it 

does not mean you will get vaginal cancer. 

But you should talk to a doctor about 

whether you need more frequent exams. 

How can I help prevent or 

lower my chance of getting 

vaginal cancer?

You can lower your chance of developing 

vaginal cancer by:

•	 Getting the HPV vaccine, if you are in the 

age group for which it is recommended. 

The vaccine protects against the types 

of HPV that most often cause cervical, 

vaginal, and vulvar cancers.

•	 Limiting your number of sexual partners to 

reduce the risk of getting HPV or HIV.

• Not smoking. Smoking harms all of your 

body’s cells, including your vaginal cells. 

If you smoke and have HPV, you have a 

higher chance of getting vaginal cancer. 

If you smoke, ask a doctor for help quitting. 

Are there ways to find vaginal 

cancer early?

The best ways to find vaginal cancer early are 

to get regular checkups and to see a doctor if 

you have any signs or symptoms. The Pap test 

does not screen for vaginal cancer. The only 

cancer the Pap test screens for is cervical 

cancer. A doctor may perform a pelvic exam to 

look for signs of vaginal cancer, such as lumps 

or changes in the vagina, or perform a biopsy to 

help diagnose vaginal cancer. If you have had 

abnormal cervical cells or cervical cancer, you 

may be at a higher risk of getting other HPVassociated cancers, like vaginal cancer. Your 

doctor may recommend more follow-up tests 

or visits to check for vaginal cancer.

19
Vulvar Cancer

What is vulvar cancer?

When cancer starts in the vulva, it is called vulvar 

cancer. The vulva is the outer part of the female 

genital organs. It has two folds of skin called the 

labia. Vulvar cancer most often occurs on the inner 

edges of the labia.

When vulvar cancer is found early, treatment is 

most effective.

Who gets vulvar cancer?

While vulvar cancer is very rare, all women are at 

risk. Each year, approximately 3,500 women in the 

United States get vulvar cancer.

20
21

What are the signs and symptoms 

of vulvar cancer?

Signs and symptoms of vulvar cancer include:

• Itching, burning, or bleeding on the vulva 

that does not go away.

•	 Color changes on the skin of the vulva, where it

is redder or whiter than normal for you.

• Skin changes on the vulva, including what 

looks like a rash or warts.

• Sores, new lumps, or ulcers on the vulva 

that do not go away.

• Pain in your pelvis, especially when you 

urinate or have sex.

If you have any of these signs for two weeks or

longer and they are not normal for you, see a doctor. 

They may be caused by something other than 

cancer, but the only way to know is to see a doctor.

What raises a woman’s chance of 

getting vulvar cancer?

There is no way to know who will get vulvar 

cancer. However, the following factors may 

increase the chance you will get it:

• Having HPV.

•	 Having a history of abnormal Pap test 

results showing abnormal cervical cells or 

having had cervical cancer.

• Having HIV or another condition that makes it

hard for your body to fight off health problems.

• Being aged 50 years or older.

• Having chronic vulvar itching or burning. 

•	 Smoking. 

If one or more of these is true for you, it 

does not mean you will get vulvar cancer, 

but talk to a doctor about whether you need 

more frequent exams.

How can I help prevent or 

lower my chance of getting 

vulvar cancer?

You can lower your chance of developing 

vulvar cancer by:

• Getting the HPV vaccine, if you are in the 

age group for which it is recommended. 

The vaccine protects against the types 

of HPV that most often cause cervical, 

vaginal, and vulvar cancers.

• Limiting your number of sexual partners 

to reduce the risk of getting HPV.

• Not smoking. Smoking harms all of your 

body’s cells, including your vulvar cells. 

If you smoke and have HPV, you have a 

higher chance of getting vulvar cancer. If 

you smoke, ask a doctor for help quitting. 

Are there ways to find vulvar 

cancer early?

The best ways to find vulvar cancer early 

are to get regular checkups and to see a 

doctor if you have signs or symptoms of 

vulvar cancer for two weeks or longer. 

The Pap test does not screen for vulvar 

cancer. The only cancer the Pap test 

screens for is cervical cancer. A doctor 

may perform a physical examination to look 

for skin changes or perform a biopsy to help 

diagnose vulvar cancer. If you have had 

abnormal cervical cells or cervical cancer, 

you may be at a higher risk of getting other 

HPV-associated cancers, like vulvar cancer. 

Your doctor may recommend more followup tests or visits to check for vulvar cancer.
Gynecologic Cancer Diagnosis

22
What should I do if my doctor says 

I have a gynecologic cancer?

If your doctor says you have a gynecologic 

cancer, you may feel scared, depressed, 

shocked, worried, angry, confused, and 

many other emotions. Everyone reacts 

differently to a cancer diagnosis. There is 

no one ‘right’ way to react. 

As you come to terms emotionally with the 

diagnosis, here are some practical things you 

can do as you, your loved ones, and doctor 

decide on the best medical course of action: 

Ask to be referred to a gynecologic 

oncologist, a doctor who is trained to 

treat gynecologic cancers. (See p. 24 

for information on locating gynecologic 

oncologists.) Gynecologic oncologists 

are not located in all geographic areas. 

If that is the case in your area, you may 

be referred to other types of doctors who 

help treat gynecologic cancer, such as 

gynecologists, medical oncologists, and 

radiation oncologists. You may have a team 

of doctors and nurses working with you to 

create a treatment plan. 

When you see a doctor next, you may want to:

•	 Develop and bring a list of questions to ask.

•	 Take notes or use an audio recorder 

during your visit.

• Bring a family member or friend to help listen 

to and understand what the doctor says. 

Before starting treatment, many experts 

recommend that you get a second opinion 

about your diagnosis and treatment plan. 

What is staging and why do I need it?

Cancer staging describes the size and 

extent of the disease in the body and

whether it has spread from its original 

site to other parts of the body. 

To find out the stage of a gynecologic 

cancer, your doctor may perform several 

tests. These results: 

• Will help the doctor develop the best 

possible treatment plan.

•	 Can be used to estimate the likely 

outcome or course of the disease.

What are the types of cancer 

treatment?

Different types and combinations of cancer 

treatment are possible, depending on the 

type of cancer and the stage at which it is 

diagnosed. Possible treatments include: 

• Surgery: A surgeon removes as much 

of the cancer as possible. The extent 

or possibility of surgery depends on 

the type of cancer, the stage, and the 

patient’s overall health.

• Chemotherapy: A doctor uses drugs to 

stop or slow the growth of cancer cells. 

These drugs also can harm healthy cells, 

which may cause side effects. Side 

effects usually get better or go away 

when chemotherapy is over.

•	 Radiation Therapy: A doctor uses high 

doses of radiation—high-energy rays—to kill

cancer cells and stop them from spreading. 

Radiation therapy does not hurt while it is 

being given, but it can cause side effects. 

You may want to talk to your doctor about 

taking part in a clinical trial. Clinical trials 

are research studies that help determine 

how well new medical approaches work. 

(See p. 24 for resources that provide more 

information about clinical trials.)

23
24

Resources

For information on gynecologic 

cancer, the Inside Knowledge: Get 

the Facts About Gynecologic Cancer 

Campaign, and Johanna’s Law, visit: 

Centers for Disease Control and Prevention

1-800-CDC-INFO 

www.cdc.gov/cancer/knowledge 

For information about treatment 

and clinical trials for gynecologic 

and other cancers, visit:

National Cancer Institute

1-800-4-CANCER 

www.cancer.gov

For information about free or 

low-cost cervical and breast 

cancer screening, visit:

CDC’s National Breast and Cervical Cancer Early 

Detection Program

1-800-CDC-INFO 

www.cdc.gov/cancer/nbccedp

For help locating a gynecologic 

oncologist, visit:

Women’s Cancer Network of the Foundation 

for Women’s Cancer

www.wcn.org
25
26

Glossary

Abdomen (AB-doh-min): The area of 

the body between the chest and pelvis 

containing the stomach, intestines, liver, 

and other organs.

Biopsy (BUY-op-SEE): A test where a 

doctor removes a small piece of tissue that 

is then examined under a microscope to look 

for abnormal cells that may be cancerous. 

Bloating (BLOHT-ing): When the area 

below your stomach swells or feels full. 

BRCA1 and BRCA2: Both are human 

genes. People with certain changes in the 

BRCA1 or BRCA2 genes are at increased 

risk of getting cancer, including breast 

and ovarian cancers. The names BRCA1 

and BRCA2 stand for breast cancer 

susceptibility gene 1 and breast cancer 

susceptibility gene 2, respectively.

CA-125: A protein that may be found 

in high amounts in the blood of patients 

with certain types of cancer, including 

ovarian cancer. It also can be found in 

high amounts when other non-cancerous 

conditions are present, such as endometriosis, 

ovarian cysts, and uterine fibroids. CA-125 

levels may also help track how well cancer 

treatments are working or if cancer has 

come back. 

Cancer (KAN-ser): A group of diseases in 

which cells in the body grow out of control. 

These abnormal cells can begin in one part of 

the body and spread to other body parts. There 

are many types of cancer. Types of cancer 

are named for the part of the body where the 

abnormal cells first started growing, even if it 

spreads to other parts of the body later. 

Cell: The basic unit that makes up all 

living things. 

Cervix (SUR-viks): The lower, narrow end 

of the uterus that forms a canal between the 

uterus and vagina.

Co-testing: When two tests (such as a Pap 

test and an HPV test) are performed at the 

same time.

DES or Diethylstilbestrol (die-eth-ilstill-BES-stroll): A man-made form of the 

hormone estrogen that was prescribed to 

pregnant women between about 1940 and 

1971 because it was thought to prevent 

miscarriages. Doctors stopped using DES 

because it was found to be unsafe.

Diagnosis (DY-ug-NOH-sis): The process 

of identifying a disease based on its signs 

and symptoms, and medical testing.

Endometriosis (END-oh-mee-tree-oh-sis): 

A condition where tissue from the lining of 

the uterus grows elsewhere in the body.

Estrogen (ES-troh-jin): A type of hormone 

made by the body that helps women develop 

and maintain female sex traits. Man-made 

forms of estrogen may be used as a type 

of birth control and to treat symptoms of 

menopause, disorders related to a woman’s 

period, and other conditions. 

Fibroids (FY-broyd): A non-cancerous 

tumor, commonly in the uterus. 

Follow-up: Visits with your doctor for more 

testing or treatment. 
27

Gene (jeen): The basic unit of heredity that 

holds information to build and maintain cells 

and pass genetic traits from parent to child. 

Gynecologic cancer (GY-neh-kuh-LAH-jik 

KAN-ser): Cancer of the female reproductive 

organs, including the cervix, fallopian tubes, 

ovaries, uterus, vagina, and vulva.

Gynecologic oncologist (GY-neh-kuhLAH-jik on-KAH-loh-jist): A doctor who 

specializes in treating cancers of the female 

reproductive organs.

Hereditary nonpolyposis colon cancer 

(her-ED-it-ayr-ee nahn-pah-lip-OH-sis 

KOHL-uhn KAN-ser): A disorder inherited 

through one’s parents that causes a 

higher-than-normal chance of developing 

colorectal cancer and certain other types 

of cancer, including uterine and ovarian 

cancers, often before the age of 50. Also 

called Lynch syndrome.

HIV or Human immunodeficiency virus 

(HYOO-mun im-YUH-noh-di-fish-uhnsee VYE-rus): The virus that causes AIDS, 

which increases one’s risk for developing 

certain cancers and infections by making 

one less able to fight off health problems. 

HPV or Human papillomavirus (HYOOmun pap-ah-LO-mah-VYE-rus): A very 

common virus passed on during sex that 

can cause changes to cells. At least 

50 percent of sexually active men and 

women will have HPV at some point in 

their lives. Most of the time, people who 

become infected with HPV will not have any 

symptoms and the infection will clear up on 

its own. However, when the infection does 

not clear up, it can cause normal cells to 

turn abnormal. Over time, these abnormal 

cells can turn into cancer of the cervix, 

vagina, or vulva. 

HPV test: A test where a doctor swabs the 

cervix for cells and then examines them to look 

for HPV. This test is recommended for women 

aged 30 years and older to have along with 

the Pap test (called co-testing) and it can be 

performed at the same time as the Pap test. It 

also is used to provide more information when, 

for women aged 21 and older, a Pap test has 

unclear results. 

Hysterectomy (HIS-teh-REK-toh-mee): 

Surgery to remove the uterus and, generally, 

the cervix. When only the uterus is 

removed, it is called a partial hysterectomy. 

When the cervix also is removed, it is called 

a total hysterectomy.

Menopause (MEH-noh-PAWZ): The time 

of life when a woman’s menstrual periods 

stop. A woman is in menopause when she 

hasn’t had a period for 12 months in a row. 

Menopause, on average, happens between 

the ages of 45 and 55 years old or when a 

woman has her ovaries removed. 

Ovaries (OH-vereez): Pair of female 

reproductive glands where the ova, or eggs, 

are formed. The ovaries are located in the 

pelvis—one on each side of the uterus. 

Ovaries produce the hormones estrogen 

and progesterone.
28

Pap test: A screening test where a 

doctor swabs the cervix for cells and then 

examines them under a microscope to look 

for changes on the cervix and early signs 

of cervical cancer, as well as precancerous 

changes on the cervix that can be treated. 

Cervical cancer is the only cancer that the 

Pap test screens for. It does NOT screen for 

ovarian, uterine, vaginal, or vulvar cancers. 

Pelvis (PEL-vis): The area below the 

stomach and in between the hip bones.

Pelvic exam (PEL-vik ex-am): An exam 

to check the health of female reproductive 

organs. This exam may be part of a 

woman’s routine health care visit. Your 

doctor will look at the outside of your 

genitals, or sex organs, to see if there are 

any problems. He or she also will look at 

and feel your internal organs—such as your 

vagina, cervix, ovaries, and uterus. It may 

include a rectovaginal exam. 

Precancer (PRE-KAN-ser): Cell changes 

that are not normal, but have not yet turned 

into cancer.

Progesterone (proh-JES-tuh-RONE): A 

type of hormone made by the body that 

plays a role in the menstrual cycle and 

pregnancy. Progesterone also can be made 

in the laboratory. It may be used as a type 

of birth control and to treat disorders related 

to a woman’s period, infertility, symptoms of 

menopause, and other conditions. 

Rectovaginal exam (REK-toh-VA-jihnul ex-am ): An exam that is sometimes 

given along with a pelvic exam to check 

for problems, especially in the uterus or 

ovaries. A doctor will feel internal organs 

through the vagina and rectum (the last 

several inches of the large intestine closest 

to the anus) with one hand while touching 

the pelvis with the other hand. 

Screening: Checking for disease when 

there are no symptoms. Cancer screening 

tests are effective when they can find 

disease early. 

Transvaginal ultrasound (tranz-VA-jih-nul 

UL-truh-SOWND): A test used to check 

the uterus, fallopian tubes, ovaries, and 

bladder for problems. A wand is inserted 

into the vagina that causes 

sound waves to bounce off organs inside 

the pelvis, creating a picture called a 

sonogram. Also called transvaginal 

sonography and TVS.

Tubal ligation (TOO-bull lye-GAY-shun): 

An operation to close the fallopian tubes. 

This procedure prevents pregnancy by 

blocking the passage of eggs from the 

ovaries to the uterus. 

Uterus (YOO-tuh-rus): The small, hollow, 

pear-shaped organ in a woman’s pelvis. 

This is the organ in which a baby grows. 

Also called the womb.

Vagina (vuh-JY-nuh): The muscular canal 

extending from the uterus to the exterior of 

the body. Also called the birth canal. 

Vulva (vuhl-vuh): The external female 

genital organs, including the clitoris, labia 

(vaginal lips), and the opening to the vagina.
The Centers for Disease Control and Prevention thanks and acknowledges 

the following people for their contributions to the development of this booklet:

Michael L. Berman, M.D., Professor, Department of Obstetrics and Gynecology, 

Division of Gynecologic Oncology, University of California, Irvine Medical Center 

Janet Daling, Ph.D., Epidemiology Faculty, Fred Hutchinson Cancer Research Center

Hope K. Haefner, M.D., Professor, Department of Obstetrics and Gynecology, 

The University of Michigan Center for Vulvar Diseases

Beth Y. Karlan, M.D., Director, Women’s Cancer Research Institute and Division 

of Gynecologic Oncology, Cedars-Sinai Medical Center

Anna-Barbara Moscicki, M.D., Professor of Pediatrics, University of California, San Francisco

George F. Sawaya, M.D., Professor of Obstetrics, Gynecology and Reproductive Sciences and 

Epidemiology and Biostatistics, Director, Colposcopy Clinic, San Francisco General Hospital, 

University of California, San Francisco

¿Necesita esta información en español? Contacto 1-800-CDC-INFO (1-800-232-4636). 

Oprima 2 para español, o visite www.cdc.gov/spanish/cancer/conozcasucuerpo.
U.S. Department of Health and Human Services 

Centers for Disease Control and Prevention

National Center for Chronic Disease Prevention and Health Promotion

Division of Cancer Prevention and Control

4770 Buford Highway, Mailstop K64, Atlanta GA 30341

CDC Publication #22-0098, Revised July 2012