Cervical Cancer Exams and Tests continued...
The most important progress that has been made in early detection of cervical cancer is widespread use of the Papanicolaou test (Pap smear) and high-risk HPV testing. A Pap smear is done as part of a regular exam. During the procedure, cells from the surface of the cervix are collected and examined for abnormalities. Diagnosis of cervical cancer requires that a sample of cervical tissue (called a biopsy) be taken and analyzed under a microscope. This would be done if the Pap smear is abnormal.
There are various diagnostic tools that can be used to identify changes in the cervix. They include:
Colposcopy is a procedure similar to a pelvic exam. It is usually used for a patient who had an abnormal Pap smear result but a normal physical exam. The examination uses a type of microscope called a colposcope to inspect the cervix. The entire area of the cervix is stained with a harmless dye or acetic acid to make abnormal cells easier to see. These areas are then biopsied. The colposcope magnifies the cervix by eight to 15 (depends on the colposcope) times, allowing easier identification of any abnormal-appearing tissue that may need biopsy. This procedure can usually be done in your gynecologist's office. If a biopsy under colposcopy suggests an invasive cancer, a larger biopsy is needed to fully evaluate your condition. Treatment will depend on stage of the cancer.
The loop electrosurgical excision procedure (LEEP) technique uses an electrified loop of wire to take a sample of tissue from the cervix. This procedure can often be performed in your gynecologist's office.
A conization (removal of a portion of the cervix) is performed in the operating room while you are under anesthesia. It can performed with a LEEP, with a scalpel ( cold knife conization) or a laser. In this procedure, a small cone-shaped portion of your cervix is removed for examination.
LEEP or cold knife conization procedures result in tissue samples in which the types of cells and how much they have spread to underlying areas can be more fully determined. They can be used to diagnose problems or to treat known problems.