Cervical Cancer Screening and Diagnosis
Screening for Cervical Cancer
Detecting cervical cancer early typically leads to better outcomes. Fortunately, screening for cervical cancer is relatively easy with two simple tests. Depending on your age, your doctor may recommend:
- Cervical cytology (Pap smear): During this test, your doctor collects a small sample of cells from your cervix. Then, a pathologist examines the sample for any indication of cervical cancer.
- HPV test: Like cervical cytology, your doctor collects a sample of cervical cells. Then, pathologists test this sample for infection with human papillomavirus (HPV).
In some cases, doctors recommend both tests to comprehensively screen for cervical cancer and HPV infection, a known cervical cancer risk factor. How frequently you need screening and what kind depend on your age and prior history of abnormal Pap smears.
Cervical Cancer Diagnosis
Doctors often diagnose suspected cervical cancer using several testing methods. In most cases, doctors first recommend:
- Pelvic examination: In almost all cases, a gynecologist begins the diagnostic process with a thorough pelvic examination. While wearing gloves, your doctor gently examines your unique anatomy for signs of cervical cancer.
- Cervical biopsy: In many cases, a gynecologist collects a small tissue sample from your cervix. Then, pathologists test the sample to determine if it is cancerous. Your doctor may use a sharp surgical tool to collect the sample, or a small, spoon-shaped instrument called a curette. In some cases, doctors use a small, thin brush to scrape cervical cells away from the cervix.
Depending on the results of your pelvic exam or biopsy, your doctor may recommend further testing. Before the test, you may have medications applied to your cervix to prevent pain. These tests may include:
- Colposcopy: An examination of your cervix using a special instrument, called a colposcope. This instrument magnifies your cervix, allowing your doctor to check for abnormal cells.
- Cone biopsy: This procedure is performed in the operating room under anesthesia and allows doctors to collect a tissue sample from deeper within the cervix.
- Loop electrosurgical excision procedure (LEEP): Doctors use a thin, slightly electrically charged wire to collect more cervical tissue for analysis.
Other tests may be necessary to determine whether cervical cancer has spread to other body tissues, such as:
- Computerized tomography (CT): CT scans combine a series of X-ray images to form precise images of soft tissues.
- Magnetic resonance imaging (MRI): Using strong magnetic fields and radio waves, MRIs produce detailed three-dimensional (3D) pictures of your reproductive system.
- Positron emission tomography (PET): Before this procedure, doctors inject a small amount of radioactive sugar into your bloodstream. This sugar collects in cells that are rapidly reproducing (such as certain gynecologic cancers), highlighting them on images.