Cervical Cancer:
Diagnosis and Staging

This page covers tests that are often used to help diagnose and stage cervical cancer.
Depending on the symptoms you have, you may also be asked to undergo other tests and investigations.
Diagnostic Tests to Determine Cancer Type

Once the doctor is sure of an abnormality, the following tests are done to determine further details about the type of cancer present.

Colposcopy

What to expect

If you have symptoms that suggest cervical cancer, or if your Pap test shows abnormal results, your physician may recommend a procure called a colposcopy.

A colposcopy is generally pain-free, unless you have an underlying condition that causes pain to your pelvic area. You can expect some minor discomfort while undergoing the test. It is important that you choose a doctor and clinical team that you are comfortable with to perform your test. Your clinician may tell you to avoid doing the test during your menstrual period.

During a colposcopy,

  • You will first be asked to undress the lower part of your body and lie on the examination table. Ask for a sheet or blanket to cover yourself while you wait for your doctor.

  • Try to relax your pelvic area, as this will make the test more comfortable for you.

  • Your doctor will first place a speculum inside your vaginal opening. The speculum is a metal or plastic instrument that keeps the vagina open so that the cervix can be seen clearly and examined using a colposcope. A colposcope is a magnifying instrument used to check for abnormal tissue.

  • In order to make any abnormal areas easier to see, your doctor will put a weak solution of acetic acid (similar to vinegar) on your cervix.

  • If any abnormal areas are seen, your doctor may recommend that a biopsy be done.

Biopsy

What to expect

A biopsy is usually the best way to tell for certain if an abnormal area is cancerous or not and is usually done immediately after the colposcopy. This procedure involves collecting a sample of cervical tissue for further analysis in a lab.

While the colposcopy procedure is generally painless, a cervical biopsy can cause discomfort, bleeding or even pain. There are several types of biopsies to diagnose cervical cancers.

  • Colposcopic biopsy: In this type of biopsy, your doctor will use a sharp tool called a biopsy forceps to remove a small sample of cervical tissue. This procedure may cause mild cramping, brief pain and slight bleeding afterward.
  • Endocervical curettage: In this procedure, a small, spoon-shaped instrument or a thin brush is inserted into the endocervical canal and used to scrape a tissue sample from the cervix. After this procedure, you may feel a cramping pain and experience light bleeding afterward.
  • Cone biopsy: A cone biopsy or conization is a procedure that allows your doctor to obtain samples of deeper layers of cervical cells for lab testing. Your doctor will remove a cone-shaped piece of tissue from the cervix. There are two methods used:
    • Loop electrosurgical procedure: This method uses a thin, low-voltage electrified wire to obtain the tissue sample. Your doctor will normally use local anaesthesia to complete this procedure.
    • Cold-knife cone biopsy: In this method, a surgical scalpel or laser is used to remove the tissue instead of the electrified wire. You will receive general anaesthesia during this operation.

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