Diagnosis

Screening

Screening tests can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer. Most guidelines suggest beginning screening for cervical cancer and precancerous changes at age 21.

Screening tests include:

• Pap test. During a Pap test, your doctor scrapes and brushes cells from your cervix, which are then examined in a lab for abnormalities.

  A Pap test can detect abnormal cells in the cervix, including cancer cells and cells that show changes that increase the risk of cervical cancer.

• HPV DNA test. The HPV DNA test involves testing cells collected from the cervix for infection with any of the types of HPV that are most likely to lead to cervical cancer.

Discuss your cervical cancer screening options with your doctor.

Diagnosis

If cervical cancer is suspected, your doctor is likely to start with a thorough examination of your cervix. A special magnifying instrument (colposcope) is used to check for abnormal cells.

During the colposcopic examination, your doctor is likely to take a sample of cervical cells (biopsy) for laboratory testing. To obtain tissue, your doctor may use:

• Punch biopsy, which involves using a sharp tool to pinch off small samples of cervical tissue.
• Endocervical curettage, which uses a small, spoon-shaped instrument (curet) or a thin brush to scrape a tissue sample from the cervix.

If the punch biopsy or endocervical curettage is worrisome, your doctor may perform one of the following tests:

• Electrical wire loop, which uses a thin, low-voltage electrified wire to obtain a small tissue sample. Generally this is done under local anesthesia in the office.
• Cone biopsy (conization), which is a procedure that allows your doctor to obtain deeper layers of cervical cells for laboratory testing. A cone biopsy may be done in a hospital under general anesthesia.

Staging

If your doctor determines that you have cervical cancer, you'll have further tests to determine the extent (stage) of your cancer. Your cancer's stage is a key factor in deciding on your treatment.

Staging exams include:

• Imaging tests. Tests such as X-ray, CT, MRI and positron emission tomography (PET) help your doctor determine whether your cancer has spread beyond your cervix.
• Visual examination of your bladder and rectum. Your doctor may use special scopes to see inside your bladder and rectum.