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Cervical cancer symptoms — DRCOG MCQ

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HardGynaecological OncologyCervical cancer symptomsDRCOG

A 45-year-old has postcoital bleeding, offensive watery discharge and a friable cervical mass. Which diagnosis best unifies the findings?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: CCervical cancer requiring urgent assessment

The best answer is “Cervical cancer requiring urgent assessment”. A friable cervical mass with contact bleeding and offensive watery discharge is concerning for cervical cancer. Cervical ectropion and cervicitis can cause contact bleeding but should not produce a malignant-appearing mass. This is a symptomatic diagnostic pathway, not a routine cervical-screening presentation, and requires urgent specialist assessment. The key distinction is between an investigation suitable for initial risk stratification and a finding that already meets an urgent suspected-cancer pathway. Persistent symptoms, postmenopausal bleeding, a suspicious mass or relevant family history must not be dismissed by one reassuring test. Referral and subsequent imaging or tissue diagnosis answer different stages of the pathway.

Reference: NHS Cervical Screening Programme: programme policy: https://www.gov.uk/government/publications/cervical-screening-programme-and-colposcopy-management/1-introduction-and-programme-policy