Cervical Cancer

At a glance

Cervical cancer is a malignant tumor that forms at the entrance of the womb (the cervix).
The cervix is the lowest part of the womb, and it is the part that connects to the vagina on the outside.

What makes it different from other cancers — it can be prevented

Human papillomavirus (HPV) infection is known to be the main cause of cervical cancer.
That is why the government supports HPV vaccination free of charge.

So cervical cancer can be blocked in two layers.

1. Vaccination — it stops infection with the virus that causes it
2. Regular screening — it finds and treats the disease at the stage before it becomes cancer

If it is found at the stage before it becomes cancer (the pre-cancerous stage),
a simple procedure that removes only part of the cervix is often all that is needed.

Finding it early changes the outcome a great deal

Based on Korea Central Cancer Registry data (2019-2023),
the 5-year relative survival rate for cervical cancer is 79.0%.

But when it is found while it is still only in the cervix, it is 94.5%.
When it is found after it has spread far, it falls to 29.1%.

When it is found decides the outcome.
And what decides that is regular screening.

This page is reference information that summarises official sources.
Always talk to your medical team about diagnosis and treatment.

There are no symptoms in the early stage

The National Cancer Information Center says
"in most cases there are no symptoms at all in the early stage, and symptoms appear only after it has progressed to some degree."

So do not wait for symptoms. This is a cancer you find through screening.

If symptoms do appear, they look like this

Abnormal vaginal bleeding — the most common symptom
The National Cancer Information Center explains that the most common symptom is abnormal vaginal bleeding.
It can appear in the situations below.

• After sex
• After exercise
• When passing stool
• After douching (rinsing the vagina)

Other symptoms

• More vaginal discharge, with an odour
• Pelvic pain, lower back pain (when advanced)
• Weight loss (when advanced)

Do not put these off

• Spotting when you are not on your period
• Repeated bleeding after sex
• Any bleeding after menopause

These symptoms also happen for reasons other than cervical cancer.
Having a symptom does not mean it is cancer, and having no symptom does not mean you are safe either.
Only a test can tell.

You are covered by the national cancer screening program (국가암검진)

• Who — women aged 20 and over
• How often — every 2 years
• Test — a cervical cytology test

It is one of the six cancers in the national screening program (stomach, liver, lung, colorectal, breast and cervical cancer),
and it has the youngest starting age.

It starts at 20.
Many people put it off, thinking "I am still young, I will go later,"
but there is a reason the government supports it from age 20.

How is the test done

This is the cervical cytology test (Pap smear) as described by the National Cancer Information Center.

"A speculum is inserted so that the cervix can be seen,
then a collection brush is used to take cells from the cervix and vagina."

It is over quickly. There is no anaesthesia, and for most people it is discomfort rather than pain.
The result comes a few days later.

A good time to have the test

• Avoid your period. If blood is mixed in, the result may not be accurate
• A few days after your period ends is good
• It is better to avoid douching or vaginal suppositories for a few days before the test

For exactly how to prepare, ask the clinic when you book.

If the result says "abnormal finding"

In most cases it is not cancer.

If the cytology test is abnormal, the usual next step is

• to repeat the test a little more often and watch it, or
• to look closely with a colposcopy and, if needed, take a tissue sample to confirm

Finding it at the stage before it becomes cancer is the point of screening.
An abnormal finding also means the screening did its job.

Please keep the follow-up date you are given.
The saddest cases are people who think "it will be fine" and come back years later.

To check whether you are due for screening this year,
see the National Health Insurance Service (국민건강보험공단).

This section is the most practical part of this page.
The government gives this vaccine free, but many people miss it because they do not know they qualify.

Who gets it free

Boys are included too. This is what people are least aware of.

| Who | Details |
|---|---|
| Boys aged 12 | Free under the national immunisation program |
| Girls aged 12-17 | Free under the national immunisation program |
| Low-income women aged 18-26 | If you receive basic livelihood benefits, or your income is 50% or less of the median income |

⚠️ Eligibility is set by year of birth and it changes every year.
To check whether your child qualifies this year, call your local public health center (보건소).
Just give the resident registration number and they will tell you right away.

How many doses

• Ages 12-14 — 2 doses (6-12 months apart)
• Ages 15-26 — 3 doses (2 months after the first dose, then 4 months later)

Having it younger means fewer doses.

Where do you get it

You can get it at designated medical institutions across the country.
Ask your local public health center, or check its website, for the nearest designated institution.

Cost

The vaccination fee is completely free.

A common misunderstanding

"Isn't it only for girls?"
No. Boys aged 12 are also eligible for free national immunisation.

"If I have had the vaccine, can I skip screening?"
No. You need both.
The vaccine does not block every type of the virus,
so you should still have screening every 2 years from age 20.

The eligible ages, the vaccine types and the scope of support keep changing.
Always check the current rules with your local public health center or on
the Korea Disease Control and Prevention Agency vaccination helper.

Where to go first

Obstetrics and gynaecology (OB-GYN). A local OB-GYN clinic is fine.

Screening, the cytology test, colposcopy and even a biopsy
can mostly be done at a local OB-GYN clinic.
You do not need to start at a large hospital.

If going to an OB-GYN feels uncomfortable

Many people hesitate because of their age or because they are not married.
A few facts make it much easier.

• National cancer screening covers every woman aged 20 and over. Marriage has nothing to do with it
• The test is over quickly. For most people it is a moment of discomfort rather than pain
• When you book, you can simply say "I am here for the national cervical cancer screening"
• If something worries you, you can mention it at the reception desk in advance
• If you would prefer a female doctor, you can call and ask before you book

You can also have the test at a screening center or a health check-up center.
If the OB-GYN sign itself feels uncomfortable, that is another way.

After a diagnosis

• Obstetrics and gynaecology / gynaecologic oncology — the center of surgery and treatment
• Radiation oncology — if you have radiation therapy
• Hematology and medical oncology — if you have chemotherapy

Do I need a large hospital

At the pre-cancerous stage (before it becomes cancer), a procedure at a local OB-GYN clinic is often all it takes.

If cancer is confirmed, you will move to a general hospital or a tertiary hospital.
A tertiary hospital needs a referral letter (진료의뢰서) for national health insurance (건강보험) to apply,
so it is best to get the referral from the place that examined you.

Be sure to bring your cytology and biopsy result sheets with you.

You can look for local clinics and large hospitals together on the map.

These are the tests described by the National Cancer Information Center.

Tests that confirm whether it is cancer

• A doctor's examination — to check whether it has spread into the vagina, pelvis, bladder or rectum
• Cervical cytology test (Pap smear) — a speculum is inserted so the cervix can be seen, then a collection brush takes cells from the cervix and vagina. It is the same test used in screening
• Colposcopy — abnormal areas of the cervix are viewed under magnification
• Biopsy — tissue is taken from the cervix and checked under a microscope. This is the test that finally decides whether it is cancer
• Conization — the cervix is cut out in a cone shape. It serves as both diagnosis and treatment

Tests that show how far it has spread

If cancer is confirmed, these are added to decide the stage.

• CT and MRI — to see invasion of nearby tissue and spread to the lymph nodes
• PET — to check for spread and recurrence
• Cystoscopy and sigmoidoscopy — to see whether it has invaded the lining of the bladder and rectum
• Intravenous pyelography (IVP) — to see whether it has invaded the ureters, bladder or urethra

Having several tests does not mean it is serious.
It is the process of deciding the treatment exactly.

With cervical cancer, treatment differs a great deal depending on the stage at which it is found.
These are the treatments described by the National Cancer Information Center.

Pre-cancerous lesions — the stage before it becomes cancer

Found here, the womb can often be kept.

• Conization — the cervix is cut out in a cone shape. It serves as both diagnosis and treatment
• Local destructive therapy — cryotherapy, radiofrequency therapy, laser therapy
• Simple hysterectomy — done when needed, through the vagina, through the abdomen, by laparoscopy or by robotic laparoscopy

Invasive cervical cancer

• Radical hysterectomy — the womb and the surrounding tissue are removed widely
• Radical trachelectomy — if you want to become pregnant, this leaves the womb in place and removes the cervix

If you are planning a pregnancy, please say so first.
It changes which operations you can choose.
Once the treatment plan is set it cannot be undone, so bring it up at the start.

Radiation therapy and chemotherapy

Depending on the stage and your condition, they are done instead of surgery, or together with surgery.

If it comes back

Options include pelvic exenteration, combined operative and radiotherapeutic treatment (CORT) and laterally extended endopelvic resection (LEER).

Which treatments you have, and in what order, differs from person to person.
Talk it through fully with your medical team before you decide.

The special cost-sharing program

If you are diagnosed with cervical cancer, you can apply for the special cost-sharing program for serious illness (산정특례).
Once you are registered, your share of the cost for care related to that cancer drops sharply,
and it applies for a set period.

The hospital that issued the medical certificate usually applies for you.
If you do it yourself, submit the registration form to the National Health Insurance Service.

Screening costs

• Cervical cancer screening is part of the national cancer screening program. Women aged 20 and over can have it every 2 years.
• Medical aid recipients, and the bottom 50% of national health insurance subscribers, can have it free.
• If screening finds something abnormal and further tests are done, that becomes medical care, and national health insurance applies.

Vaccination costs

If you are eligible for the national HPV immunisation, the vaccination fee is completely free.
Check with your local public health center. (See the section "HPV vaccination")

Other things

• Depending on your income, you may qualify for the medical cost support program for cancer patients.
• For treatment choices tied to a pregnancy plan, timing matters more than cost. Do not put it off.

The rules and your share of the cost change.
What follows is a summary as of the reference date. Before you apply, always
check the current rules with the National Health Insurance Service.