Cervical Cancer Stages

After someone is diagnosed with cervical cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes the extent of the cancer in the body. It helps determine how serious the cancer is and how best to treat it. The stage is one of the most important factors in deciding how to treat the cancer and determining how successful treatment might be.

To determine the cancer’s stage after a cervical cancer diagnosis, doctors try to answer these questions:

  • How far has the cancer grown into the cervix?
  • Has the cancer reached nearby structures?
  • Has the cancer spread to the nearby lymph nodes or to distant organs?

Information from exams and tests is used to determine the size of the tumor, how deeply the tumor has invaded tissues in and around the cervix, and its spread to distant places (metastasis). For more information see Cancer Staging.

The FIGO (International Federation of Gynecology and Obstetrics) staging system is used most often for cancers of the female reproductive organs, including cervical cancer. For cervical cancer, the clinical stage is used and is based on the results of the doctor's physical exam, biopsies, imaging tests, and a few other tests that are done in some cases, such as cystoscopy and proctoscopy. It is not based on what is found during surgery. If surgery is done, a pathologic stage can be determined from the findings at surgery, but it does not change your clinical stage. Your treatment plan is based on the clinical stage.

Cervical cancer stage ranges from stages I (1) through IV (4). 

As a rule, the lower the number, the less the cancer has spread. A higher number, such as stage IV, means a more advanced cancer. And within a stage, an earlier letter means a lower stage. Cancers with similar stages tend to have a similar outlook and are often treated in much the same way.

Cervical cancer staging can be complex. If you have any questions about your stage, please ask your doctor to explain it to you in a way you understand. (An explanation of the FIGO system is in the stage table below.) 

 

FIGO Stage

Stage description

I

 

The cancer cells have grown from the surface of the cervix into deeper tissues of the cervix.

Cancer has not spread to nearby lymph nodes.

Cancer has not spread to distant sites.

 

IA

There is a very small amount of cancer, and it can be seen only under a microscope.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IA1

The area of cancer can only be seen with a microscope and is less than 3 mm (about 1/8-inch) deep.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IA2

The area of cancer can only be seen with a microscope and is between 3 mm and 5 mm (about 1/5-inch) deep.

It not has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IB

This includes stage I cancer that has spread deeper than 5 mm (about 1/5 inch) but is still limited to the cervix.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IB1

The cancer is deeper than 5 mm (about 1/5-inch) but not more than 2 cm (about 4/5-inch) in size.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IB2

The cancer is at least 2 cm in size but not larger than 4 cm.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IB3

The cancer is at least 4 cm in size and limited to the cervix.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

II

 

The cancer has grown beyond the cervix and uterus, but hasn't spread to the walls of the pelvis or the lower part of the vagina.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIA

The cancer has grown beyond the cervix and uterus but has not spread into the tissues next to the cervix (called the parametria).

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIA1

The cancer is not larger than 4 cm (about 1 3/5 inches).

It not has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIA2

The cancer is 4 cm or larger.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIB

The cancer has grown beyond the cervix and uterus and has spread into the tissues next to the cervix (the parametria).

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

III

 

The cancer has spread to the lower part of the vagina or the walls of the pelvis. The cancer may be blocking the ureters (tubes that carry urine from the kidneys to the bladder).

It might or might not have not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIIA

The cancer has spread to the lower part of the vagina but not the walls of the pelvis.

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIIB

The cancer has grown into the walls of the pelvis and/or is blocking one or both ureters causing kidney problems (called hydronephrosis).

It has not spread to nearby lymph nodes.

It has not spread to distant sites.

 

IIIC

The cancer can be any size.

Imaging tests or a biopsy show the cancer has spread to nearby pelvic lymph nodes (IIIC1) or para-aortic lymph nodes (IIIC2).

It has not spread to distant sites.

IV

 

The cancer has grown into the bladder or rectum or to far away organs like the lungs or bones.

 

IVA

The cancer has spread to the bladder or rectum or it is growing out of the pelvis.

 

IVB

The cancer has spread to distant organs outside the pelvic area, such as distant lymph nodes, lungs or bones.

 

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Bhatla N, Aoki D, Sharma DN, and Sankaranarayanan R. FIGO Cancer Report 2018. Cancer of the cervix uteri. Int J Gynecol Obstet. 2018; 143 (Suppl):22-36. 

Last Revised: January 3, 2020

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