What are the key symptoms and signs that should prompt further investigation for cervical cancer in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Key symptoms and signs that should prompt further investigation for cervical cancer in primary care include:

  • Unexplained vaginal bleeding, especially postcoital bleeding or bleeding between periods.
  • Unexplained postmenopausal bleeding, which requires urgent referral regardless of previous cervical screening results.
  • Persistent or unexplained vaginal discharge.
  • Appearance of the cervix on examination consistent with cervical cancer, such as visible lesions or abnormalities.
  • Palpable vaginal mass or mass at the entrance to the vagina.

Women presenting with these symptoms or signs should be urgently referred to colposcopy or gynaecology oncology for specialist assessment using a 2-week cancer pathway. Referral should not be delayed due to previous normal cervical screening results or pregnancy status.

Educational content only. Always verify information and use clinical judgement.