Gynaecological Cancer Awareness Month: Know Your Body, Know the Signs

Gynaecological cancer is not one disease. The term covers five main cancers: womb, ovarian, cervical, vulval and vaginal cancer. Each has different risk factors, symptoms and tests, but they share one important message: persistent or unusual symptoms deserve attention.

Most symptoms will have a non-cancerous explanation. However, knowing what is normal for you - and seeking advice when something changes - can support earlier diagnosis and more effective treatment.

Symptoms not to ignore...

Please arrange a medical assessment if you experience:

• Bleeding after the menopause, even if it happens only once.
• Bleeding after sex, between periods or periods that become unusually heavy or irregular.
• Persistent bloating, an increase in abdominal size or pelvic discomfort.
• Feeling full quickly, loss of appetite or unexplained weight loss.
• A change in bowel or bladder habits, including needing to pass urine more frequently.
• Persistent vulval itching, soreness, skin changes, a lump or an ulcer.
• Unusual vaginal discharge, particularly if it is blood-stained.
• Persistent pelvic, abdominal or lower-back pain.

These symptoms do not necessarily mean cancer. They should not, however, be dismissed as simply part of ageing, the menopause, stress, irritable bowel syndrome or HRT without an appropriate assessment.

Screening is designed for people without symptoms. If you have symptoms, do not wait for a screening invitation or rely on a home test.

Cervical cancer prevention: HPV vaccination and screening

Almost all cervical cancers are linked to persistent infection with a high-risk type of human papillomavirus, or HPV. HPV is extremely common and usually clears naturally. A positive HPV result does not mean that somebody has cancer, has been unfaithful or has recently acquired the infection; HPV can remain undetectable for many years.

The HPV vaccine protects against the HPV types responsible for most cervical cancers and several other cancers. It works best before exposure to HPV, which is why it is routinely offered to young people, but some adults may also be eligible through NHS catch-up or targeted programmes.

The HPV (human papillomavirus) vaccine has been highly effective in reducing the incidence of cervical cancer, particularly when administered before exposure to HPV. Since the introduction of the national HPV vaccination programme in England in 2008, cervical cancer rates have fallen substantially among vaccinated women. Research published in the BMJ found that women offered routine HPV vaccination at age 12–13 had an 83.9% lower incidence of cervical cancer compared with an unvaccinated reference cohort. By mid-2020, the vaccination programme was estimated to have prevented approximately 687 cases of cervical cancer and more than 23,000 cases of severe cervical pre-cancer (CIN3) in England. These findings demonstrate the significant impact of HPV vaccination in preventing cervical cancer and highlight its importance as a key component of cervical cancer prevention.

Vaccination substantially reduces risk, but it does not remove it completely, so cervical screening remains important when invited.

Cervical screening is now primarily an HPV test. A clinician takes a sample from the cervix and, if high-risk HPV is found, the sample can be checked for abnormal cell changes. This helps identify people who may need closer monitoring or treatment before cancer develops.

HPV self-sampling: a major step forward

For some people with a cervix, traditional cervical screening can be difficult because of pain, previous trauma, disability, cultural concerns, embarrassment or a busy life.

In August 2026, NHS England began a phased rollout of HPV self-sampling for eligible people aged 30 to 65 who had not attended after previous screening invitations. Those invited can collect a vaginal sample using a swab and return it for high-risk HPV testing. NHS England

If high-risk HPV is detected, a clinician-taken cervical sample is still required to check for cell changes. People who normally attend clinician-led screening should continue to do so. Self-sampling is currently an additional, invitation-based route intended to make screening accessible to more people - it is not a test for investigating symptoms.

This development has the potential to improve screening participation and reduce inequalities, while giving women greater privacy and choice.

Investigating abnormal bleeding: could the WID-easy test help?

Abnormal bleeding, particularly postmenopausal bleeding, is the most common warning sign of womb or endometrial cancer. The usual investigation may involve a pelvic examination, transvaginal ultrasound, endometrial biopsy and, where necessary, hysteroscopy.

One newer development is the WID-easy test, a PCR-based molecular test designed to detect DNA methylation patterns associated with womb cancer. Methylation is a biological change affecting how genes are switched on and off. For this test, cells are collected from the vagina or cervix and analysed for a cancer-associated molecular signature.

Early studies suggest that WID-easy could become a useful triage test, helping identify who needs urgent invasive investigation and potentially sparing some low-risk women an unnecessary hysteroscopy or biopsy. The NHS Innovation Accelerator reports evidence of high specificity and suggests that the test could substantially reduce unnecessary procedures. NHS Innovation Accelerator

This is an encouraging innovation, especially for women with bleeding related to HRT or benign gynaecological conditions. However, it is not yet a universal NHS screening test and should not be regarded as a stand-alone way to rule out cancer. Its precise place in routine care will depend on continuing real-world evaluation, availability and clinical guidance.

Blood tests and CA125: useful, but not a diagnosis

CA125 is a protein that can be measured in the blood. It is often requested when symptoms could suggest ovarian cancer, such as persistent bloating, pelvic pain, feeling full quickly or urinary frequency.

A raised CA125 can support the decision to arrange imaging, usually an ultrasound, but the result must be interpreted carefully:

• A raised result does not mean ovarian cancer. Endometriosis, fibroids, menstruation, pregnancy, pelvic infection and other non-cancerous conditions can increase CA125.
• A normal result does not completely exclude ovarian cancer, particularly at an early stage or with certain tumour types.
• CA125 is not currently recommended as a general screening test for people without symptoms or a recognised high inherited risk.
• Once ovarian cancer has been diagnosed, CA125 may help monitor treatment response or possible recurrence in some patients.

Other blood markers may be used when the clinical picture suggests a particular ovarian tumour type, especially in younger patients. Researchers are also studying combinations of proteins, circulating tumour DNA and other molecular markers, but there is not yet a single blood test that can reliably screen the general population for every gynaecological cancer.

The key message is that blood tests complement clinical assessment and imaging; they do not replace them.

What might change diagnosis in the future?

Research is moving towards tests that detect cancer earlier, more accurately and less invasively.

Molecular and methylation testing

Tests such as WID-easy look for molecular alterations rather than relying only on what can be seen on a scan. In the future, methylation signatures may help distinguish benign bleeding from cancer, identify several cancers from one sample or guide the urgency of further investigation.

Liquid biopsies

A liquid biopsy searches blood or another body fluid for tumour DNA, tumour cells or other cancer-related material. Potential uses include detecting residual disease after treatment, identifying relapse before it becomes visible on a scan and selecting targeted treatment.

The challenge is sensitivity: very early cancers may release only tiny amounts of tumour material. Large clinical trials are needed to show that earlier detection through these tests genuinely improves outcomes without causing unnecessary investigations.

Artificial intelligence

Artificial intelligence may help specialists interpret ultrasound, MRI, digital pathology slides and colposcopy images. It could support more consistent risk assessment and help prioritise suspicious findings, but it should supplement rather than replace specialist clinical judgement.

Inherited and tumour genetic testing

Testing for inherited variants, including BRCA1, BRCA2 and Lynch syndrome-related genes, can clarify future cancer risks for patients and their relatives. Testing the tumour itself may reveal vulnerabilities that can be targeted with specific drugs.

Genetics is increasingly becoming part of routine cancer care, although the most appropriate test depends on the cancer type, pathology and family history. Genetic results require careful interpretation and, where appropriate, counselling.

Treatment is becoming more personalised

Treatment no longer depends only on where a cancer began. Increasingly, it is guided by the tumour's molecular characteristics.

Important developments include:

• PARP inhibitors for selected ovarian cancers, particularly cancers with BRCA mutations or related DNA-repair weaknesses.
• Immunotherapy for some advanced or recurrent womb and cervical cancers, selected partly through biomarkers such as mismatch-repair deficiency or microsatellite instability.
• Antibody-drug conjugates, which deliver a cancer-killing drug to cells carrying a particular molecular target.
• Targeted treatments based on features such as HER2, folate receptor alpha or other tumour markers.
• Fertility-sparing treatment for carefully selected people with very early disease, supported by specialist surveillance.
• Less invasive surgery and sentinel lymph-node assessment, which may reduce complications while maintaining effective cancer treatment.

Not every option is suitable for every patient, and access depends on the cancer type, stage, biomarker results, previous treatments and current national guidance. Clinical trials remain essential for establishing which innovations offer meaningful improvements in survival and quality of life.

Prevention and early action still matter most

While newer tests and treatments are exciting, the most effective actions available now remain straightforward:

1. Attend cervical screening when invited, or use an NHS self-sampling kit if you are eligible and receive an invitation.
2. Take up HPV vaccination when offered.
3. Report postmenopausal bleeding promptly, even if it happens only once.
4. Seek review for persistent bloating, pelvic pain, appetite changes or urinary symptoms.
5. Check the vulval area and report persistent itching, soreness, colour changes, thickened skin, lumps or ulcers.
6. Discuss your family history, particularly multiple relatives with ovarian, womb, bowel, breast or related cancers.
7. Ask questions about investigations, including their purpose, limitations, alternatives and pain-relief options.

The future of gynaecological cancer care is likely to involve easier sampling, smarter molecular tests and treatment tailored to each tumour. But awareness remains one of our most powerful tools. You know your body best: if something feels different, persistent or unexplained, seek medical advice.

This blog provides general information and does not replace individual medical assessment. New or unexplained symptoms should be discussed with an appropriately qualified healthcare professional.