Cervical cancer tests
This page is about the tests you may have to diagnose cervical cancer. There is information about
Cervical cancer tests
Your doctor will suggest more tests if you've had an abnormal result after a cervical screening test, or if you have symptoms that could be caused by cervical cancer. Most women who have an abnormal result or suspicious symptoms do not have cancer.
A doctor or specialist nurse uses an instrument called a colposcope to look at the surface of the cervix. They will take a biopsy of any abnormal areas. For most women, colposcopy is painless and you can go home straight afterwards. If your doctor finds an area of abnormal cells, you may have treatment there and then. But you can choose to come back for treatment if you prefer. Colposcopy is safe if you are pregnant. In most cases, any treatment for precancerous cells can be planned for after you've had the baby. Your doctor will be very careful about taking biopsies.
This is a minor operation that you usually have under general anaesthetic. You will probably stay in hospital overnight. The doctor cuts out a cone of tissue from your cervix. This is sent to the laboratory for examination under the microscope.
Afterwards you may have a gauze pack in your vagina to help stop bleeding. It is normal to have bleeding for up to 4 weeks after a cone biopsy. You will need to avoid heavy housework or lifting for the first week or so. You shouldn't do vigorous exercise or have sexual intercourse for 4 to 6 weeks after your cone biopsy.
You can view and print the quick guides for all the pages in the diagnosing cervical cancer section.
Your doctor or nurse will suggest more tests if you've had an abnormal result after a cervical screening test, or if you have symptoms which could be caused by cervical cancer. These tests are different ways of looking at the cervical cells more closely. To find out more about the abnormality, and to see whether you have cervical cancer, your specialist may ask you to have one of these tests
This may be all that you need to have done. Do remember that most women who have an abnormal result, or suspicious symptoms, do not have cancer. Treating abnormal precancerous cells will stop a cancer from developing. Cone biopsy may successfully treat the problem by removing the abnormal area. If your doctor sees an obvious abnormality with the colposcope, they may treat you there and then. But you will have to go for follow up tests to make sure the abnormal cells don't come back.
If any of the tests do show you have an invasive cervical cancer, you will need further tests and more treatment. Invasive means that the cancerous cells have started to grow into the deeper layers of the cervix, for example, into the muscle layer.
This is another examination of the cervix similar to when you have a cervical screening test. A doctor or specialist nurse uses a colposcope to look at the surface of the cervix. This is really just a large magnifying glass that they use to closely examine the skin like covering of the cervix. It doesn't go inside you. But by looking through it, the nurse or doctor can see changes that may be too small to see with the naked eye. They will take a biopsy of any abnormal areas.
For most women, this is a painless examination. It may be a little uncomfortable because you will be in the position you need to be in for the liquid based cytology screening test (smear test). Some people find it uncomfortable to stay in that position for more than a couple of minutes, but other than that, it should be fine.
You usually have colposcopy in the outpatient clinic, or in a local community hospital. You lie on your back on the couch with your feet drawn up and your knees apart. As with the screening test, if you can't get into that position for any reason, the doctor or specialist nurse may be able to do the examination with you lying on your side with your knees drawn up.
The doctor or nurse puts in a speculum to open up the vagina. And then they look through the colposcope at the surface of the cervix. The examination takes up to 20 minutes. If they need to take biopsies, you can have some local anaesthetic injected into the cervix first. You will be able to go home as soon as the colposcopy is over.
If your doctor or specialist nurse finds an area of abnormal cells, you may have treatment there and then. They may call this see and treat. But you can choose to go back for treatment if you prefer.
LLETZ (Large Loop Excision of the Transformation Zone) means cutting out the area of the cervix where the abnormal cells develop. The transformation zone is the area just inside the cervical canal. LLETZ is the most common treatment used in the UK. It is simple and quick to carry out, works well and can be done under local anaesthetic. It also provides a clear tissue sample for the laboratory to examine. There are quite a few other treatment options, including laser, cold coagulation and cone biopsy, and these can work equally well. Look at the section about treating abnormal smears for more information about other treatments that you may have.
Sometimes the doctor or specialist nurse cannot see clearly enough because the abnormal cells go further up into the cervical canal than can be seen with a colposcope. If they cannot see all the cells that are abnormal you will need to have either a LLETZ or a cone biopsy.
This is a minor operation that you usually have under general anaesthetic. You will probably stay in hospital overnight.
While you are under anaesthetic the doctor cuts out a cone of tissue from your cervix. The cone includes the whole area of the cervical canal where there might be abnormal cells. The cone of tissue is sent to the laboratory for examination under the microscope.
When you wake up after the cone biopsy, you may have some gauze packed into your vagina to help stop any bleeding. If you have a pack, you will probably have a tube to drain urine from your bladder as well (a catheter). This is because the gauze pack presses on the bladder and the tube that carries urine out of the body (the urethra). Your nurse or doctor will take the pack out before you leave hospital the following day. It is normal to have bleeding for up to 4 weeks after a cone biopsy.
A 2010 Cochrane review found that immediate blood loss and bleeding after cone biopsy is reduced by treatment with a drug called vasopressin. The drug tranexamic acid can also reduce bleeding after cone biopsy. You can read this review of preventing blood loss after treatment for abnormal cells in the Cochrane Library. It was written for researchers and specialists so is not in plain English.
You will probably have period type pains when you wake up. If you do, tell your nurse and ask for some painkillers. You can take painkillers home with you if you need to, but the pains usually only last a couple of hours.
When you get home, try to rest as much as you can for the first week or so. You do not have to stay in bed. But you mustn't be too active either. Don't do any heavy housework or carry heavy loads. It will help if you can arrange for a relative or friend to help you for a few days, particularly if you have children to look after. You shouldn't do any vigorous exercise or have sexual intercourse for 4 to 6 weeks after your cone biopsy. By that time your cervix will have healed.
You can have a colposcopy if you are pregnant. It is perfectly safe for you and your baby, and will not affect the delivery. It won't affect your ability to get pregnant in future either. In most cases, any treatment for pre cancerous cells can be planned for after you've had the baby. Your doctor will be very careful about taking biopsies.
Your doctor will not suggest a cone biopsy if you are pregnant unless he or she suspects there is a cervical cancer. Cone biopsy during pregnancy can weaken the cervix and bring on a miscarriage. There is more information about the effect cone biopsy might have on future pregnancy in this section.
Before you leave hospital, whether after a colposcopy or a cone biopsy, make sure you know how you will be given the results. You may be asked to go back to the hospital for an outpatient appointment to see the specialist to get the results. Or the results may be sent in the post.
If you have abnormal cells on your cervix, you will be asked to go back to hospital to have them treated. There is information about treating abnormal cervical cells in this section.
If you had abnormal cells and have had a cone biopsy, the area with the abnormal cells will usually have already been removed. As long as the abnormal cells were completely removed and there is no sign of cervical cancer, you will not need any further treatment. But you will need regular cervical screening tests for a while to keep an eye on the area.
If you are diagnosed with cervical cancer, then your doctor will ask you to go back to hospital for further tests.
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