It’s also one of the most preventable cancers in women because of available screenings and vaccinations.
While regular screenings are the most important thing you can do to detect precancerous cells, there are other things you also need to know to spot symptoms early.
Screening for Cervical Cancer
The most important step to find precancerous cervical cells is getting screened. Tests can pick up changes in cervical cells before they become cancer.
You lie on an exam table and your doctor will use a speculum to keep your vagina open. It also allows them to see your cervix. Next, they’ll use a small brush to swab some cells from your cervix. The cells are sent to a lab where they’re checked for signs of cancer.
You can get an HPV test alone or with your Pap test, known as co-testing, every five years starting after age 30. Human papillomavirus is the most common sexually transmitted disease in the United States, and the high-risk types of the virus cause almost all cervical cancers. If you test positive for HPV, that doesn’t mean you’ll get cervical cancer. If you're over age 30, doctors recommend you get both tests every 3-5 years.
Symptoms of Cervical Cancer
Most women in the early stages of cervical cancer don't have any symptoms. That's why Pap and HPV screening tests are so important.
Symptoms don't usually start until the cancer spreads to other organs and tissues. If you do have symptoms, you might notice:
- Abnormal bleeding (between periods, after sex, or after menopause)
- Heavier than normal periods
- Pain during sex
- Unusual vaginal discharge that might contain blood
These symptoms do not necessarily mean you have cancer. Other diseases or infections cause them, too. See your gynecologist if you notice any of these symptoms.
How Is Cervical Cancer Diagnosed?
If you have an abnormal Pap test and other symptoms of cervical cancer, your gynecologist will want to find out more about your medical history and your family’s. They’ll likely run more tests to find out if you have cancer cells in your cervix, and check your lymph nodes to see if cancer has spread.
Some of the tests your gynecologist might use to check for cancer cells include:
Colposcopy. During this test, your doctor will use an instrument called a colposcope, which looks a lot like a microscope, to get an up close look at your cervix. You’ll lie on an exam table and they’ll use a speculum to keep your vagina open. Next they’ll rub a solution of acetic acid (similar to vinegar) on your cervix. This liquid can help them see any abnormal cells. It might burn a little.
Cervical biopsies. Your doctor might also remove a small piece of tissue during your colposcopy to check for cancer. This is known as a colposcopic biopsy. Other types of biopsies include:
- Endocervical curettage uses a thin instrument called a curette to take a sample of cells from the inside of your cervix.
- Loop electro-surgical excision procedure (LEEP) uses a thin wire heated by an electric current to remove cells.
- Punch biopsy uses a tool called biopsy forceps to remove tissue.
Cone biopsy is another, more invasive, way for your doctor to take a tissue sample, so it’s usually performed in a hospital. It can also treat some early-stage cervical cancers. Your doctor removes a cone-shaped piece of tissue from your cervix with either a LEEP, scalpel or laser.
Cells taken from your cervix from any type of biopsy will be sent to a lab and checked under a microscope for signs of cancer. You might have mild cramps and bleeding after these procedures.
What If it’s Cancer?
If your biopsy shows you have cervical cancer, the next step is to see if it has spread, and where. Your doctor might order one or more of these tests:
Chest X-ray. A chest X-ray will look to see if cancer has spread to your lungs.
Positron emission tomography (PET). Your doctor might order a PET scan if they think your cancer has spread but isn’t sure where. It uses a type of radioactive sugar that cancer cells absorb. A special camera can spot the cells that have absorbed the sugar.
What Does ‘Stage’ Mean?
After all of the tests results are back, your doctor will use them to determine if and how far your cancer has spread, which will show them what stage it is in. Staging classifies the cancer by how much is in your body and where it has spread when it’s diagnosed. Knowing the stage can help your medical team plan the right treatment for you.
Stages of cervical cancer are:
Stage 0. Cancer is only on the surface of the cervix and has not grown into deeper tissues.
Stage I. The cancer has grown into the cervix and may be growing into the body of the uterus. It may also have spread to nearby lymph nodes but has not spread distantly.
Stage II. The cancer has spread outside of the cervix and uterus. It may have reached the upper part of the vagina. It may involve local lymph nodes but has not spread to distant sites.
Stage III. The cancer has spread to the lower part of the vagina or the walls of the pelvis. It may or may not involve the nearby lymph nodes but has not spread to distant sites.
Stage IV. This is the most advanced stage. The cancer has spread to other parts of the body, like the bladder, rectum, lungs, liver, or distant lymph nodes.
Your stage of a cancer won’t be changed if your cancer gets worse or comes back. Your doctor will always refer to it by the stage it was when it was diagnosed.