Most Common Symptom in Cervical Cancer Assessment
Abnormal vaginal bleeding (Option A) is the most commonly occurring symptom when assessing for cervical cancer.
Clinical Presentation Pattern
The earliest stages of cervical carcinoma may be asymptomatic or present with specific bleeding patterns 1:
- Post-coital bleeding (bleeding after intercourse) is a classic presentation 1
- Intermenstrual bleeding (bleeding between periods) is another characteristic symptom 1
- Post-menopausal bleeding may occur in older women 1
- Intermittent spotting is frequently reported 1
These bleeding patterns collectively represent the most common symptomatic presentation, though early symptoms are often not recognized by patients 1.
Supporting Evidence for Other Symptoms
Abnormal Vaginal Discharge (Option B)
While vaginal discharge does occur, it is described as a watery vaginal discharge and is listed alongside bleeding symptoms rather than as the primary presentation 1. In research examining women with cytologic smears suggestive of adenocarcinoma, 22 of 23 symptomatic women (86%) presented with abnormal vaginal bleeding, not discharge 2.
Pelvic Pain (Option C)
Pelvic pain is not mentioned as a primary presenting symptom in the major cervical cancer guidelines 1. It typically occurs with more advanced disease rather than at initial presentation.
Ectopic Pregnancy (Option D)
This is completely unrelated to cervical cancer presentation and represents a distinct obstetric emergency 1.
Clinical Context and Prevalence
The probability that a woman with post-coital bleeding in the community has cervical cancer ranges from 1 in 44,000 for women aged 20-24 years to 1 in 2,400 for women aged 45-54 years 1, 3. Despite the relatively low absolute risk, abnormal vaginal bleeding remains the hallmark symptom requiring investigation 1.
Key Clinical Pitfall
Many early cervical cancers are asymptomatic, which is why screening programs exist 1. When symptoms do occur, various forms of abnormal vaginal bleeding predominate over all other presentations 1, 2.