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

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.