Cervical Cancer: Diagnosis

Your provider is often the first person to find signs of cervical cancer. During your visit, your provider will do a physical exam. They’ll also ask you questions. Be prepared to answer questions about yourself, such as:

• Your health history
• Any symptoms you have
• Your family history

If your provider thinks you might have cervical cancer, they’ll do exams and tests to know for sure. Your provider may use 1 or more of these tests:

• Pelvic exam
• Pap and human papillomavirus (HPV) tests
• Colposcopy
• Biopsy

When you get a pelvic exam, you can stay in the comfort of your provider’s office. Before the exam, you’ll be asked to remove your clothes from the waist down and put on a medical gown. Then, you’ll lie on your back on an exam table and put your feet in supports called stirrups.

In this position, your provider can look at and feel your cervix and other reproductive organs. They will put a plastic or metal tool called a speculum inside your vagina to see part of your vagina and cervix. After removing the speculum, your provider will put 1 or 2 gloved fingers into your vagina. They’ll use their other hand to gently press on your stomach. This is to feel other organs and check for anything unusual.

Your provider may also do a recto-vaginal exam. During this exam, your provider puts 1 finger in your rectum and another finger in your vagina. This helps them feel the tissue between and around these 2 organs.

Depending on what your provider sees and feels, they may do more tests.

A Pap test shows cervical cell changes. An HPV test shows if you have an infection with the types of HPV that can lead to cervical cancer.

Both tests can be done in your provider's office. Your provider will use a speculum to open your vagina and look at part of your vagina and cervix. They’ll use a small, soft brush, or spatula to take cells from your cervix and vagina. You may feel some discomfort during the exam. But the tests last only for a few seconds.

A medical professional will then look at the cells under a microscope. They’ll check for precancer, cancer, and HPV infection.

A colposcopy lets your provider find any abnormal areas on your cervix. To do this test, your provider will use a lighted magnifying tool called a colposcope.

During the exam, your provider will use a speculum to hold open your vagina and look closely at your cervix. They’ll wash your cervix with a vinegar-like liquid. This liquid helps show changes on your cervix. If your provider sees areas that look different, they’ll remove them and send them to a lab for testing. This part of the test is called a biopsy.

If your provider wants to test part of your cervix, they’ll do a cervical biopsy. They may do this test 1 of 3 ways:

• Endocervical curettage (endocervical scraping). This type of biopsy uses a small tool (curette or brush) to scrape cells or tissue from the cervix. You may have this done during a colposcopy.
• Cone biopsy (conization). This type collects larger pieces of tissue from the cervix. Your provider may use a knife, laser, or heated wire (called a LEEP cone) to remove a cone-shaped piece of the cervix. You may be given medicines so that you don’t feel any pain. Or your provider will numb your cervix. Afterward, you may have some cramping, bleeding, or other discharge.
• Punch biopsy. A small piece of tissue is removed from the cervix using a hollow circle-shaped tool. More than 1 part of the cervix may be biopsied.

Once your provider gets the results, they’ll contact you. Together, you can talk about what the results mean for you and any other tests you may need.