Adenocarcinoma of the cervix is a less common type of cervical cancer. It can cause symptoms such as vaginal bleeding. Treatment can include radiation therapy and surgery.

Adenocarcinoma of the cervix starts in the glandular cells of the endocervix. The endocervix forms the inner part of the lining that leads into the uterus.

Some evidence suggests adenocarcinoma of the cervix may be more aggressive than other types of cervical cancer, but early diagnosis and treatment may help improve a person’s outlook.

This article explores the symptoms and causes of adenocarcinoma of the cervix. It also looks at how doctors diagnose the condition, treatment options, and more.

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In its early stages, adenocarcinoma of the cervix may not cause any symptoms.

When symptoms do occur at an early stage, they can include one or more of the following:

  • vaginal bleeding after menopause
  • pain during or after sexual intercourse
  • vaginal bleeding following sexual intercourse
  • watery vaginal discharge, often with a strong odor or that may contain blood
  • unusual vaginal bleeding, such as between menstrual periods or heavier or longer periods than usual

Advanced cervical cancer can cause additional symptoms. Advanced cancer may have spread into local tissue or spread to distant areas of the body. Some possible symptoms include:

  • abdominal pain
  • fatigue or feeling tired
  • painful or difficult bowel movements with possible bleeding
  • dull backache
  • pain or difficulty when urinating with possible blood present
  • leg swelling

The symptoms associated with adenocarcinoma of the cervix are not specific. A person should consider talking with a healthcare professional for pre-symptom screening or if they develop symptoms.

Early diagnosis and treatment may help improve outcomes.

Learn more about the possible causes of bleeding between periods.

The primary cause of adenocarcinoma of the cervix is an infection from high risk types of human papillomavirus (HPV). HPV types 16 and 18 account for about 70% of all cervical cancer cases.

HPV is the most common sexually transmitted infection (STI) in the world. It can be transmitted with close skin-to-skin contact or any sexual contact, even if the person does not have any symptoms.

Certain risk factors can increase a person’s chances of developing cervical cancer from an HPV infection. They include:

  • having a weakened immune system, such from HIV or another condition
  • obesity
  • taking hormonal birth control
  • giving birth to several babies
  • smoking or secondhand smoke exposure

Exposure to diethylstilbestrol (DES) in the womb is a known risk factor for clear cell adenocarcinoma, a rare type of adenocarcinoma of the cervix. Clear cell adenocarcinoma accounts for about 4% of the total number of cases.

Doctors provided DES to people during pregnancy between 1940 and 1971 to help prevent miscarriage and early labor. If a person has concerns about their exposure to DES in the womb, they may wish to contact a doctor for advice or discuss this at a routine screening.

Learn more about other causes of cervical cancer besides HPV.

Doctors may suspect adenocarcinoma of the cervix or another form of cervical cancer if a person has symptoms or a screening test reveals the potential presence of cancer.

To diagnose adenocarcinoma of the cervix, a doctor may order one or more tests, such as:

  • Physical exam: A doctor may perform a colposcopy. It involves inserting a speculum into the vagina to look at the cervix.
  • Imaging tests: Imaging tests may help with diagnosis and staging. They can include PET-CT scans, ultrasounds, chest X-ray, or MRI scans.
  • Blood tests: A doctor may order a complete blood count or blood chemistry study.
  • Biopsy: A doctor may order a biopsy, which involves taking a sample of cervical tissue to check for cancer.
  • Visual testing: A doctor may use different instruments to get a better look at the bladder area or rectum to check for cancer spread and invasion. To look at the bladder, a doctor may perform a cystoscopy. To view the rectum, they may perform a sigmoidoscopy.

In the early stages, current recommendations for treating adenocarcinoma of the cervix include either radiation therapy or surgical removal.

Surgery may involve removing only the cancer but may also include removing additional tissue, such as the uterus and lymph nodes.

Doctors may be able to perform fertility-sparing surgery in people who may wish to have children. A person can discuss this with a doctor to determine the best option for them.

According to a 2016 article, chemotherapy often has less effect on adenocarcinoma of the cervix than other treatments and may not improve outcomes.

However, doctors may recommend chemotherapy alongside radiation therapy for the treatment of adenocarcinoma of the cervix.

According to a 2019 review of research, adenocarcinoma of the cervix accounts for 10–25% of the cases of cervical cancer.

The National Cancer Institute (NCI) states that squamous cell carcinoma accounts for up to 90% of all cervical cancer cases.

However, the NCI also notes that, in rare cases, a person may have a mixed type, known as mixed carcinoma or adenosquamous carcinoma.

The best form of prevention for adenocarcinoma of the cervix comes from getting an HPV vaccination. The vaccines help prevent some of the highest risk types of HPV.

Doctors recommend females get vaccinated between 9 and 14 years old.

Cervical screening typically begins at age 25 years, though doctors may recommend screening from age 21.

Some studies indicate that adenocarcinoma of the cervix has a poor outlook compared with other types of cervical cancer. However, early diagnosis and treatment can help improve outcomes.

Before the cancer spreads, surgery may fully remove the cancer and improve a person’s chances of not having a recurrence.

Once the cancer spreads, a person’s outlook generally gets worse, with a lower likelihood of survival.

Learn more about whether cervical cancer is curable.

Data on survival rates of adenocarcinoma of the cervix is often part of data on other, more common types of cervical cancer.

Some information indicates that the 5-year survival rate for stage 1 and 2 cell carcinoma of the cervix is between 81.5% and 91%. The 10-year survival rate is about 57%.

It is not clear from studies whether this particular subtype is more aggressive than other forms of adenocarcinoma of the cervix.

The American Cancer Society reports that the 5-year relative survival rate of cervical cancer in general is as follows:

  • Local: 91%
  • Regional (local spread): 60%
  • Distant (spread to distant areas of the body): 19%
  • All stages combined: 67%

A relative survival rate helps give an idea of how long a person with a particular condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, it means a person with the condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. A person can consult a healthcare professional about how their condition may affect them.

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Adenocarcinoma of the cervix is a less common type of cervical cancer. It may have a worse outlook than other types, but early diagnosis and treatment may help improve outcomes. Treatment typically involves radiation therapy and surgery.

Prevention involves getting an HPV vaccination and regular cervical screening as an adult.

A person experiencing symptoms should contact a doctor to investigate the underlying cause.