The pedals… the snot… the jelly that your doctor never fully clears. Yes, paps are (in some ways) painful, but cervical cancer is one of the leading causes of cancer death in the United States, according to the Centers for Disease Control and Prevention. Now it doesn’t even make the top 10 thanks to Paps, which can detect problems before they become cancerous.

However, the American Cancer Society estimates that 13,240 new cases of cervical cancer will be diagnosed in 2018, 31 percent of which will be fatal. And according to the CDC, six out of 10 cervical cancers occur in women who have never had a Pap test or have not had one in the past five years. (Of course, according to the CDC, all women between the ages of 21 and 65 should get a Pap smear every three years between the ages of 21 and 30, and every five years between the ages of 30 and 65.)

“In fact, one of the biggest risk factors for cervical cancer is not having a Pap smear within the last five years,” says Eloise Chapman-Davis, M.D., a gynecologic oncologist at Weill Cornell Medicine, New York-Presbyterian.

However, he notes that you shouldn’t just rely on the Pope to flag up an issue. It is important to pay attention to the symptoms of cervical cancer, which occur when the cancer is more advanced. Translation: If you have symptoms of cervical cancer, it’s a good idea to talk to your doctor right away and get checked out.

  1. Completely abnormal vaginal bleeding
    “One of the most common symptoms of cervical cancer is vaginal bleeding between periods, after intercourse, or after menopause,” says Tarane Shirazian, M.D., a gynecologist at NYU Langone Health. Abnormal vaginal bleeding is generally a sign of cervical cancer, Chapman-Davies added, because it means the cervical cancer has spread to surrounding tissue. Call your doctor as soon as possible.
  2. Severe episodes of AF
    It’s not about your period lasting a day longer or suddenly getting a little darker. “Instead, it’s when your period suddenly lasts two weeks instead of four days, or comes twice in one month,” says Shirazian. But to be on the safe side, it’s worth talking to your gynecologist about any changes in your cycle (heavier, lighter, whatever) that last at least two cycles, she says.
  3. WTF-Vaginal discharge
    Bleeding is normal, but your discharge can be a symptom of a variety of vaginal health issues. “With cervical cancer, you may have a foul-smelling, pink, brown, bloody discharge with lumps of tissue or something called necrosis,” says Shirazian. “Because masses and tumors secrete fluid, this can contribute to continuous, watery discharge for no apparent reason,” says Chapman-Davis. Go ahead and call your doctor.
  4. Pelvis, back and leg pain
    Pelvic pain can be a sign of changes in the cervix, but cervical cancer can spread to the bladder, bowel, lungs and liver, Chapman-Davies said. “Then you might get back pain and leg pain,” he says. “But it’s usually associated with very advanced cases, because the cervix doesn’t affect a lot of nerves.” Talk to your primary care physician to rule out cervical cancer or other neurological causes.
  5. Great fatigue
    Most cervical cancer symptoms do not appear until it is in an advanced stage, so some symptoms are common with all cancers. “Fatigue is one of those symptoms,” says Shirazian. One of the reasons for this: Abnormal vaginal bleeding, one of the main symptoms of cervical cancer, reduces the amount of red blood cells and oxygen in the body and makes you feel tired all the time, which often has no other explanation. If you have chronic fatigue, your doctor will check your iron and red blood cell levels. Watch out for these five signs
  6. Feeling like you’re going to Barf – all the time
    Persistent nausea and indigestion can be symptoms of cancer, including cervical cancer, Shirazian said. That’s because when cervical cancer is advanced, the cervix can swell into the abdomen, compressing the gastrointestinal tract and stomach, causing acid reflux, she said. Nausea can be a symptom of cervical cancer or other problems, so talk to your doctor before seeing a gynecologist.
  7. Lose weight out of nowhere
    The same factors that cause cervical cancer-related nausea can lead to unintended weight loss, Shirazian says. (Think about it: the stomach can’t hold a lot of food.) Plus, if you’re constantly nauseous, you’re less likely to want to eat.

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