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Diagnosis of Cervical Cancer

The diagnosis of cervical cancer usually begins in your doctor’s office during a routine pelvic exam and Pap test. To learn about the pelvic exam and Pap test, see cervical cancer screening. If your Pap test shows abnormal changes or unhealthy cell growth in the cervix, further testing will need to be done to determine if you have cancer, an infection, or some other condition.

Squamous Cell Carcinoma of the Cervix
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First, a complete personal and family medical history will be done, including information about possible risk factors related to cervical cancer. You will also have a physical exam.

Testing

The initial diagnosis of cervical cancer can be made from the screening Pap test done in the doctor’s office. However, additional diagnostic tests are necessary to plan effective treatment.

Diagnostic tests will determine the nature of the abnormal cell growth of the cervix. Diagnostic tests include:

Colposcopy —In this procedure, a colposcope, an instrument that shines a light on the cervix and magnifies the view, is used to examine your genitals, vagina, and cervix closely.

The speculum is placed into your vagina and opened slightly to view the cervix. A vinegar or iodine solution is swabbed onto the cervix and vagina. This solution makes abnormal tissue turn white so areas that need to be evaluated can be identified. If abnormal cells are found during a colposcopy, a biopsy may be done.

Biopsy —During a biopsy, the doctor removes a small amount of cervical tissue for examination. There are several procedures used to obtain biopsies, including:

  • Cone biopsy, also known as cold cone biopsy or cold knife cone biopsy—a procedure that uses a laser or a surgical scalpel to remove tissue
  • Loop electrosurgical excision procedure (LEEP)—a procedure that uses an electric wire loop to slice off a thin, round piece of tissue
  • Endocervical curettage—a procedure that uses a small, spoon-shaped instrument called a curette to scrape tissue from inside the cervical opening

If the area of abnormal cell growth is small, these biopsy procedures may be able to remove all of the affected area. The tissue removed during biopsy is sent to a laboratory to be analyzed.

Staging

If cancer is found, your prognosis and treatment depend on the location, size, and stage of the cancer and your general health.

After cervical cancer is found, more tests are done to find out if the cancer has spread beyond the cervix, and, if so, to what extent. This process is called staging, which may be done with:

  • Imaging studies including:
    • CT scan
    • MRI scan
    • Positron emission tomography
  • Surgical staging
  • Sentinel lymph node biopsy

The following staging system is used to classify cancer of the cervix:

  • Stage 0—The abnormal cells are found only in the first layer of cells lining the uterus.
  • Stage I—Cancer involves the cervix but is still confined to the uterus. This stage has six levels depending upon the size of the cancer: IA, IA1, IA2, IB, IB1, and IB2.
  • Stage II—Cancer has spread to nearby areas but is still inside the pelvic area. This stage has two levels depending on whether the cancer has spread to the upper two-thirds of the vagina (IIA) or into the pelvis (IIB).
  • Stage III—Cancer has spread throughout the pelvic area. This stage has two levels depending on whether the cancer has spread to the lower third of the vagina (IIIA) or more broadly into the pelvis (IIIB).
  • Stage IV—Cancer has spread to other parts of the body. This stage has two levels depending on which organs the cancer has spread to: bladder, rectum or both (IVA); or, more distant organs (IVB).

Revision Information

  • Cervical cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/cervicalcancer/index. Accessed January 6, 2014.

  • Cervical cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 7, 2013. Accessed January 6, 2014.

  • Cervical cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/cervical. Accessed January 6, 2014.

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