Gynecologic cancers: Early detection and understanding symptoms can save lives

According to the American Cancer Society, it is estimated that 117,660 new cases of gynecologic cancers will be diagnosed in American women in 2026. Of those, an estimated 34,570 women will die from a gynecologic cancer.

However, many women are unaware of their potential risk for developing a gynecologic cancer and the symptoms that indicate they may have cancer.

What is gynecologic cancer?

According to the , gynecologic cancer is any cancer that starts in a woman’s reproductive organs. The five primary gynecological cancers include uterine/endometrial, ovarian, cervical, vulvar, and vaginal, all posing unique symptoms and risk factors. 

“Most people who get a gynecologic cancer don’t have obvious risk factors,” said Warner K. Huh, M.D., MSHA, chair of the UAB Department of Obstetrics and Gynecology. “With these types of cancers, what women can control is being screened regularly and seeking medical advice if something doesn’t seem right with their bodies.”

Any woman can be at risk for any gynecologic cancer. Risk tends to increase with age, and there is always a heightened possibility of cancer due to family history or race. Lifestyle choices such as chronic smoking and obesity can impact one’s risk for developing a gynecologic cancer. For instance, there is a clear correlation between higher rates of uterine/endometrial cancers in women with obesity. 

Signs and symptoms

A primary challenge in the detection of gynecologic cancers is that many of the signs and symptoms are common for women to experience regularly with menstruation or as side effects from another condition. Furthermore, symptoms range from woman to woman, so it can be hard to definitively say that each woman will experience the same thing.

“What women need to be looking for is the abnormal frequency and duration of symptoms, even if the symptoms are ones that don’t seem out of the ordinary,” said Dr. Huh. “If they are experiencing symptoms like persistent bloating, ongoing bleeding or persistent pelvic pain, they need to be aware of the persistence and length of these symptoms as they may indicate that a formal medical evaluation is needed.”

While each woman’s reaction may be different, the signs and symptoms below are general indicators for each cancer. As Dr. Huh notes, it is important for women to use these symptoms as guides, ultimately knowing that they are the only ones who know for certain that there is something atypical, uncomfortable, or intolerable about the symptoms they are experiencing.

• Cervical: vaginal bleeding unrelated to one’s period; pain or bleeding during intercourse; postmenopausal bleeding; significant or foul-smelling vaginal discharge
• Ovarian: loss of appetite or feeling full quickly; gas; bloating; nausea; frequent urination; pelvic pain or pressure; significant unintentional weight loss or gain; abdominal distention causing clothes to become much tighter
• Uterine/Endometrial: perimenopausal bleeding; irregular bleeding between menstrual cycles; heavier and/or longer menstrual bleeding; pelvic pain
• Vaginal: perimenopausal bleeding; pain or bleeding during intercourse; pelvic pain and constipation; vaginal mass
• Vulvar: constant itching and/or burning sensation in the vulva (outer part of female genitals); change in skin color of the vulva, including rashes, sores or warts, or the presence of a non-healing lesion

Prevention and detection

Women may undergo cervical cancer screening, when due, at their annual OB/GYN appointment – screening that can ultimately save their lives if they are positive for cancer. The Pap test and HPV test are both recommended options for cervical cancer screening, though a woman may receive one or both depending on her screening plan. For women at average risk, the American College of Obstetricians and Gynecologists recommend starting screening at age 21, while the American Cancer Society recommends beginning screening at age 25. Screening is generally conducted every three to five years, depending on the test used, and a doctor may suggest an appropriate schedule. 

The Pap test – also referred to as a cervical cytology – tests for cervical cancer through the collection of cells from the cervix. The test can detect active cancerous cells as well as detect changes that may identify a risk for cancer in the future. 

The HPV test is designed to detect the presence of high-risk types of human papillomavirus (HPV) which can cause changes in cervical cells that may lead to cancer. 

“We know that, with most malignancies, screening is critical and early detection can help save the life of the woman,” Dr. Huh said. “The biggest takeaway for women is to stay mindful of their bodies, report any symptoms that appear even remotely irregular, and make sure they have their screenings conducted on schedule. These actions can ultimately save their life.”

What about the HPV vaccine?

Dr. Huh strongly advises that all women – and men – receive the HPV vaccine to protect against cancers caused by human papillomavirus. In women, the HPV infection can cause cervical, vaginal, and vulvar cancers, so the vaccine provides added protection for this population. The recommendation is for girls and boys starting as young as age 9 up until age 26 to receive the required dosages. According to the Centers for Disease Control and Prevention (CDC), adults ages 26 through 45 may also choose vaccination after discussing it with their health care provider. 

If abnormal symptoms are experienced, talk to a doctor about these changes. Pay attention and know what is or is not normal.

Cervical cancer is preventable through vaccination against cancer-causing types of HPV, periodic cervical screenings and, if necessary, treatment of cervical lesions before they develop into cancer. Despite the availability of both a primary preventative vaccine and effective screening with Pap and HPV testing, Alabama ranks fourth in mortality and incidence of cervical cancer in the United States, with great disparities across races and counties. 

In 2023, UAB in partnership with the Alabama Department of Public Health and the American Cancer Society, launched Wipe Out Cervical Cancer ­– a statewide action plan to eliminate cervical cancer as a public health problem in Alabama.

Learn more information on the statewide action plan to eliminate cervical cancer as a public health problem in Alabama.