Cervical cancer is a serious medical problem that can spread within the body and cause death. Most women who have had HPV infections, however, do not develop cervical cancer. HPV 16 and 18 strains are responsible for nearly 50% of high grade cervical pre-cancers. Other risk factors include smoking, a weak immune system, birth control pills, starting sex at a young age, and having many sexual partners, but these are less important. Genetic factors also contribute to cervical cancer risk. Cervical cancer typically develops from precancerous changes over 15 to 20 years. About 90% of cervical cancer cases are squamous cell carcinomas, 10% are adenocarcinoma, and a small number are other types. Diagnosis is typically by cervical screening followed by a biopsy. Medical imaging is then done to determine whether or not the cancer has spread.