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Grading and staging cervical cancer

The grade of a cervical cancer describes how quickly the cancer might grow or spread. The stage describes its size and how far it has spread. 

If you are having lots of tests or have been told the grade and stage, you may feel overwhelmed with information, confused about what you are being told or worried about what it means. We are here to help you navigate all of this, whether you want to discuss next steps or simply have someone listen.

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On this page:

What is a grade and stage?

Your healthcare team will look at the stage and grade of the cancer to help decide what treatment is suitable for you.

The grade shows:

  • how different the cancer cells are to healthy cells
  • how the cancer cells might behave in the body, including how quickly they might grow and spread. 

The stage shows:

  • the size of the cancer
  • whether the cancer has spread.

Read about making treatment decisions >

Grading cervical cancer

A pathologist or histopathologist is an expert on how diseases work in the body. They will look at your cells under a microscope to give the cells a grade from 1 to 3:

  • Grade 1. These cells look similar to healthy cells. They tend to grow more slowly than higher grades. 
  • Grade 2. These cells look a bit like healthy cells and may grow a bit quicker.
  • Grade 3. These cells look very different to healthy cells. They tend to grow more quickly which means they are more likely to spread. Grade 3 cancers might need more intensive treatment than lower grades.

Staging cervical cancer 

When cancer develops, the cancer cells grow and multiply and form a tumour. The tumour will start off small and contained within a small area – this is an early stage. The tumour can grow larger and spread to areas nearby – which you might hear being called ‘locally advanced’. Eventually, cancer can spread to other areas in the body, this is an advanced stage.

Cervical cancer is given a stage from 1 to 4.

The cancer is only in the cervix. It hasn’t spread to the surrounding tissue, nearby organs, or anywhere else in the body.

Stage 1A 

The cancer is small and can only been seen with a microscope.

  • Stage 1A1 – The cancer is less than 3mm deep into the cervix.
  • Stage 1A2 – The cancer is between 3 to 5mm deep into the cervix.

Stage 1B

The cancer is slightly bigger and may be seen without a microscope. 

  • Stage 1B1 – The cancer is 5mm or more deep into the cervix. It is less than 2cm wide.
  • Stage 1B2 – The cancer is 2mm or more deep into the cervix. It is less than 4cm wide.
  • Stage 1B3 – The cancer is 4cm or more wide.

The cancer has spread a small way outside of the cervix.

Stage 2A 

The cancer has spread into the top of the vagina.

  • Stage 2A1 – The cancer is less than 4cm wide.
  • Stage 2A2 – The cancer is 4cm or more wide.

Stage 2B 

The cancer has spread into the top of the vagina and into the tissue.

The cancer may have spread into the lower part of the vagina, the pelvic wall, or the lymph nodes. It may also cause the kidneys to swell (hydronephrosis) or stop working properly. 

Stage 3A 

The cancer has spread to the lower part of the vagina, but not the pelvic wall. 

Stage 3B 

The cancer has spread to the pelvic wall, or has caused the kidneys to swell or stop working properly. 

Stage 3C

The cancer has spread to the lymph nodes. 

  • Stage 3C1 – The cancer has only spread to the pelvic lymph nodes.
  • Stage 3C2 – The cancer has spread to the lymph nodes above the pelvic area (paraaortic lymph nodes).

The cancer has spread to the bladder, back passage (rectum) or to further areas of the body.

  • Stage 4A – The cancer has spread to parts of the body close to the cervix, such as the bladder or rectum.
  • Stage 4B – The cancer has spread to parts of the body further away from the cervix, such as the lungs, liver or bones.

Stages of cervical cancer

An illustration of cervical cancer cells or tumours from stage 1 to stage 3.

Other words and phrases you might hear

Your healthcare team might also use the terms early stage, locally advanced, or advanced cervical cancer. It is important to ask them what they mean by these terms, but here is a rough guide:   

  • Early-stage cervical cancer includes stages 1A to 1B1.
  • Locally advanced cervical cancer usually includes stages 1B2 to 4A.
  • Advanced-stage or metastatic cervical cancer usually means stage 4B.

Grading and staging FAQs

Some healthcare professionals use ‘stage 0’ to describe changes to cells in the cervix (abnormal cells). This can be confusing, as cell changes are not cancer. Stage 0 may also be called cervical intraepithelial neoplasia 3 (CIN3) or, less commonly, carcinoma in situ (CIS).

Read about cervical cell changes >

If you have a type of cancer called small cell cervical cancer, they might use a slightly different system which is used for small cell lung cancer. The stage will be called:

  • limited disease, where the cancer is small and still within the cervix
  • extensive disease, where is has spread beyond the cervix.  

Read about small cell cervical cancer >

The FIGO staging system used for cervical cancer was updated in 2018. If you were diagnosed with cervical cancer before this, the stage may be different to the ones we describe on this page. 

We know you might be worried or have questions about this change. It is best to speak with your hospital healthcare team, who can explain the changes.

More information about grading and staging cervical cancer

Grading and staging can be confusing, so it’s important to take the time you need to understand everything – remember that your healthcare team are there if you have any questions.

We are here for you too. Our trained volunteers can listen and help you understand what’s going on via our free Helpline on 0808 802 8000.

Check our Helpline opening hours >

 

Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.

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If you have general questions about grading and staging cervical cancer, our panel of medical experts may be able to help. They can’t give you answers about your individual situation or health – it’s best to speak with your GP or healthcare team for that.

Use our Ask the Expert service >

Treating cervical cancer >

Find out about different treatment types.

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Date last updated: 
03 Nov 2020
Date due for review: 
03 Nov 2023
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