Cervical cancer is cancer that starts in the cervix. The cervix is the lower part of the uterus (womb), located between the bladder and the rectum, that opens into the vagina. Cervical cancer usually develops slowly, and starts with the growth of abnormal cells that are not cancerous. The appearance of these abnormal cells may be the first evidence of cancer that develops years later. They can be detected with a pelvic exam or a Pap test. If abnormal cells on the surface of the cervix spread deeper into the cervix, or to other tissues or organs, the disease is then called cervical cancer, or invasive cervical cancer. It’s different from cancer that begins in other parts of the uterus and requires different treatment. The following have been suggested as risk factors for cervical cancer: Infection with the human papillomavirus (HPV) Infection with the human immunodeficiency virus (HIV) or other condition that weakens the immune system Smoking Having first had sexual intercourse at a young age Having many sexual partners, and having partners who have had sexual intercourse at a young age and/or have had many partners themselves Early detection of cervical problems is the best way to prevent cervical cancer. Routine, annual pelvic examinations and Pap tests can detect precancerous conditions that often can be treated before cancer develops. Invasive cancer that does occur would likely be found at an earlier stage. Women should begin having regular Pap tests at age 21. An HPV screening test can be added to the Pap test at age 30 or older, and in younger women to follow up on an abnormal Pap test. Because certain strains of HPV have been found to cause most cases of cervical cancer, scientists developed a vaccine against HPV. The first one became available in 2006. The one in use today in the United States is Gardasil 9, which protects against nine different types of HPV. It protects females and males against some of the most dangerous HPV genotypes and the health problems that the virus can cause, such as genital warts and cancer. Most children get the vaccine when they are 11 or 12 years old, but it is approved for use through age 45. When cervical problems are found during a pelvic examination, or abnormal cells are found through a Pap test, a cervical biopsy may be performed. There are several types of cervical biopsies that may be used to diagnose cervical cancer, and some of these procedures that can completely remove areas of abnormal tissue may also be used for treatment of precancerous lesions. Some biopsy procedures only require local anesthesia, while others require a general anesthesia. Treatment for cervical cancer may include surgery, radiation therapy, and/or chemotherapy.