Tests used to evaluate cervical cancer include the following.
The doctor gently scrapes the outside and inside of the cervix and takes samples of the cells for testing.
In this examination, the doctor feels a woman’s uterus, vagina, ovaries, fallopian tubes, cervix, bladder, and rectum to check for any unusual changes. A Pap tet is often done at the same time. If the doctor finds abnormal changes to the cervix during a pelvic examination and a Pap test, the doctor may repeat the Pap test. The doctor may also test for HPV at the same time. Certain kinds of HPV, such as HPV16, are seen more often in women with cervical cancer and may help confirm a diagnosis. Many women carry HPV, so HPV testing alone is not an accurate test for cervical cancer. But if the Pap tests show some cellular abnormality, and the HPV test is also positive, the doctor may suggest additional diagnostic tests.
The doctor may do a colposcopy to check the cervix for abnormal areas. A special instrument called a colposcope (an instrument that magnifies the cells of the cervix and vagina, similar to a microscope) is used. The colposcope gives the doctor a lighted, magnified view of the tissues of the vagina and the cervix. The colposcope is not inserted into the woman’s body and the examination is not painful, can be done in the doctor’s office and has no side effects. It can be done on pregnant women.
A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. There are several types of biopsies. One common method uses an instrument to pinch off small pieces of cervical tissue. Others can include:
- Endocervical Curettage (ECC) Sometimes, the doctor wants to check an area inside the opening of the cervix that cannot be seen during a colposcopy. Using a small, spoon-shaping instrument called a curette, the doctor scrapes a small amount of tissue from inside the cervical opening.
- Loop Electrosurgical Excision Procedure (LEEP) An electrical current is passed through a thin wire hook. The hook removes tissue for examination in the laboratory. A LEEP may also be used to remove a precancers or an early stage cancer.
- Conization (Cone Biopsy) A cone-shaped piece of tissue is removed from the cervix. Conization may be done as treatment to remove precancers or early stage cancers.
This procedure allows the doctor to view the inside of the bladder and urethra (canal that carries urine from the bladder) with a cystoscope (a thin, flexible tube with a camera). A cystoscopy is used to determine whether cancer has spread to the bladder.
This procedure allows the doctor to view the colon and rectum using a sigmoidoscope (a thin, flexible tube with a camera). A proctoscopy is used to see if the cancer has spread to the rectum.
This procedure allows the doctor to view the abdominal area with a laparoscope (a thin, flexible tub with a camera)
An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help doctors determine if the cancer has spread to the lungs. An intravenous urography is a type of x-ray that is used to view the kidneys and bladder.
Computed Tomography (CT or CAT Scan)
A CT scan created a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.
Magnetic Resonance Imaging (MRI)
An MRI uses magnetic fields, not x-rays, to produce detailed images of the body.
Positron Emission Tomography (PET) Scan
In a PET scan, radioactive sugar molecules are injected into the body. Cancer cells absorb sugar more quickly than normal cells, so they light up on the PET scan. PET scans are often used to complement information gathered from the CT scan, MRI and physical examination.