Diagnosing Cervical Cancer
There are various procedures that may be used in diagnosing cervical cancer, which include:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
Pap test: A procedure that uses a small brush to collect cells from the surface of the cervix and the area around it. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called a Pap smear.
Human papillomavirus (HPV) test: A laboratory test used to check DNA or RNA for certain types of HPV infection. Cells are collected from the cervix and DNA or RNA from the cells is checked to find out if an infection is caused by a type of HPV that is linked to cervical cancer. This test may be done using the sample of cells removed during a Pap test. This test may also be done if the results of a Pap test show certain abnormal cervical cells.
Regular screening can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. The American Cancer Society encourages women to begin cervical cancer screening at age 21, which includes:
Pap test every 3 years for women 21-29 years of age. Unless there are abnormal Pap results, HPV testing is not recommended.
Pap test and HPV test (co-testing) every 5 years for women 30-65 years of age. It also is acceptable to have a Pap test alone every 3 years.
No screening is necessary for women age 65 or older who have had regular screening within the last 10 years and no serious pre-cancers within the last 20 years.
No screening is needed for women who have had a total hysterectomy unless the surgery was performed as a treatment for cervical pre-cancer or cancer.
If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis:
Colposcopy: A procedure in which a colposcope (a lighted, magnifying instrument) is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette (spoon-shaped instrument) or a brush and checked under a microscope for signs of disease.
- Biopsy: If abnormal cells are found in a Pap test, the doctor may do a biopsy. A sample of tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. There are several different types of biopsies:
Punch biopsy: The doctor uses a sharp tool to pinch off small samples of cervical tissue. This is usually done in the doctor’s office.
Cone biopsy: Removal of a larger, cone-shaped sample of cervical tissue.
Loop electrosurgical excision procedure (LEEP): The doctor uses an electric wire loop to slice off a thin, round piece of cervical tissue.
Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervix. Some doctors may use a thin, soft brush instead of a curette.
When the tissue is removed from the cervix this may cause some bleeding or other discharge. The area usually heals quickly. Some women also feel some pain similar to menstrual cramps. If you are experiencing pain, talk with your doctor about medicine that can help.
Women with abnormal cervical cells only on the surface may want to read the NCI booklet Understanding Cervical Changes: A Health Guide for Women. It tells about abnormal cells and describes treatments.