The Pap test is a routine screening test used to identify abnormal cell changes of the cervix and to screen for cervical cancer. Regular Pap test screening is the single most important tool in identifying and treating cervical cell changes before they progress to cervical cancer. If cervical cancer is suspected, your doctor will take a medical history and perform a physical exam, including a pelvic exam and a Pap test. Several follow-up tests may be needed for evaluation and treatment.

Tests to confirm a diagnosis of cervical cancer include:

• A colposcopy and cervical biopsy, to find out whether and where cancer cells are on the surface of the cervix.
• An endocervical biopsy (or curettage), to find out whether cancer cells are in the cervical canal.
• A cone biopsy or loop electrosurgical excision procedure (LEEP). These tests are sometimes recommended to remove cervical tissue for examination under a microscope.

If you are pregnant, a colposcopy and cervical biopsy can be done to confirm cervical cancer.

Tests to determine the extent (stage) of cervical cancer include:

• A cone biopsy or loop electrosurgical excision procedure (LEEP). These tests are sometimes recommended to determine the spread of cancer in cervical tissue.
• A cystoscopy, to look at the interior lining of the bladder and the urethra to determine whether the cancer has spread to the urinary system.
• A proctoscopy, to look at the lower part of the large intestine ( colon) to determine whether the cancer has metastasized.
• An intravenous pyelogram, to see whether there is any blockage of a kidney.
• A chest X-ray, to check for cancer cells that have spread from the cervix.

Other surgeries may be done to determine the extent of cervical cancer. For more information, see the Surgery section of this topic.

Tests to guide treatment decisions include:

• A complete blood count (CBC), to check for anemia and other abnormal blood values.
• A chemistry screen, to find out how the liver and kidney are working.
• A computed tomography (CT) scan of the abdomen and pelvis, to determine which treatment choice is needed depending on the spread of cancer in the abdomen and pelvis.
• A magnetic resonance imaging (MRI) of the abdomen and pelvis. This test can also help determine which treatment will be recommended depending on the spread of cancer in the abdomen and pelvis.
• A positron emission tomography (PET). This test is sometimes used to evaluate which organs the cancer has spread to.

Early Detection

As part of your routine gynecological exam, you should have a Pap test. A Pap test is used to identify abnormal cell changes of your cervix and to screen for cervical cancer. The Pap test is the most effective screening test to prevent the development of cervical cancer. Abnormal cervical cells on a Pap test are classified according to their degree of abnormality. Treatment decisions are guided by the kind of changes seen in the cells. In North America, abnormal cells are classified using the Bethesda system (TBS). The Bethesda system or other classification systems are used in other parts of the world.