Cervical Cancer - Exams and Tests
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:
Screening Benefit According to Age
Cervical cancer mortality, usually occurring among unscreened women, increases with age, with the maximum mortality for white women between the ages of 45 and 70 years and for black women in the 70s.[1,2] (Also available online.) Mortality among women with negative Papanicolaou (Pap) screening is low at all ages. Screening by Pap testing with associated diagnostic testing and treatment is effective in reducing the incidence of all histologies and stages of invasive cervical cancer.[3] The benefit...
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- 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
The recommended Pap test schedule is based on your age and things that increase your risk. For most women, it is best to have a Pap test every 1 to 3 years. Talk to your doctor about when to have your first Pap test and how often to have this test.
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