Medical oncologist David Spriggs confers with colleagues on a case of cervical cancer - today considered one of the most treatable cancers when diagnosed early.
To diagnose cervical cancer, the most commonly used method is the Pap test.
Pap Test
A Pap test is most commonly used to screen for and detect the possibility of a cervical cancer or dysplasia (precancer).
Video
Gynecologic cancer specialists explain how cervical cancer is diagnosed and the importance of annual Pap smear tests.
(3:00)
During a Pap test, the doctor first inserts a lubricated instrument (called a speculum) into the vagina to enlarge the opening. The doctor then takes a sample of mucus and cells by gently scraping the cervix. This test is not painful; some patients report just a few seconds of minor discomfort.
The cells obtained from the Pap smear are sent to a lab to be analyzed under a microscope. Collection, sampling, screening, and interpretation of Pap smears all require considerable experience and skill to ensure an accurate diagnosis.
Colposcopy & Biopsy
If an abnormality is found during a Pap test, a gynecologist may perform a colposcopy, which is the examination of the cervix using a colposcope (a lighted magnifying instrument attached to magnifying binoculars). A gynecologist may also perform a biopsy by removing a tiny section of the surface of the cervix for microscopic examination. A pathologist will examine the sample to see if it contains precancer or cancer cells.
Cone Biopsy or Conization
If abnormal cells are found or if diagnosis is not clear after a colposcopy, a surgeon may remove a slightly larger, cone-shaped piece of tissue (called a cone biopsy or conization). At Memorial Sloan-Kettering, cone biopsies are often performed with a loop electrosurgical excision procedure (LEEP), in which an electrical current is passed through a thin wire loop to remove the sample tissue. LEEP takes only about ten minutes under local anesthetic and can be performed in the doctor's office. The cone biopsy can also serve as a method of treatment, completely removing many precancers and early cancers. More than 90 percent of cervical cancers can be halted with this technique without further treatment.
Imaging Tests
If your doctor suspects that the cancer may have spread beyond the cervix, you may have a chest x-ray, CT scan of the abdomen and pelvis to check for metastatic disease, and/or MRI scan to determine the extent of local disease.
Memorial Sloan-Kettering radiologists have established the value of pelvic MRI in determining the extent of local involvement in a patient's cervical cancer. We have also been assessing the utility of the PET scan as a means of determining if cancer has spread. [PubMed]
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