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Diagnosing cervical cancer

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 18, 2022.

A thorough and accurate cancer diagnosis is the first step in developing a cervical cancer treatment plan. Your integrated team of cervical cancer experts will use a variety of advanced tests and tools for diagnosing cervical cancer, evaluating the disease and developing your individualized treatment plan. Throughout your treatment, we'll use imaging and laboratory tests to track the size of the tumors, monitor your response to treatment, and modify your plan when needed.

Tools and tests used for diagnosing cervical cancer include:

Pap test

A Pap test is usually the first step in determining cervical health and is often performed as part of routine screening. Most women are advised to get a Pap test starting at age 21. Depending on your age and risk, your doctor may also suggest an additional test for infection of human papillomavirus (HPV), because prior infection with high-risk types of HPV has been linked to an increased risk of cervical cancer.

Pelvic exam

A doctor manually examines the vagina, cervix, uterus, fallopian tubes, ovaries and rectum for things like nodules or bumps, which may be explored in greater detail with imaging technology.

Colposcopy

A doctor uses a special microscope, called a colposcope, to examine the cervix. The colposcope is designed to provide an enlarged view of the areas, allowing your doctor to observe any abnormal tissue. If abnormal tissue is identified, the tissue is biopsied.

Biopsies

Two types of biopsies used to diagnose cervical cancer are the cone biopsy/LEEP and the sentinel lymph node biopsy:

Cone biopsy/LEEP: When Pap test and colposcopy results indicate cervical carcinoma, your doctor may perform a cone biopsy/LEEP to confirm the diagnosis. The doctor removes a cone-shaped piece of tissue from the cervix using a surgical scalpel. During a LEEP, an electrified wire loop is used to remove the tissue. The tissue is then sent to a pathologist.

Sentinel lymph node biopsy: This test involves identifying, removing and examining the sentinel lymph node(s)—the first lymph node(s) to which cancer cells are most likely to spread from a primary tumor—may help determine if cancer has spread beyond the cervix. Removing only one or two lymph nodes also may avoid complications that can come with surgery to remove 10 to 30 lymph nodes.

Imaging tests

CT scan: A CT scan reveals a detailed, 3-D image of the abdomen and pelvis. After a physical exam, a CT scan may be performed to locate a tumor before surgery. A CT scan may also be used to determine tumor size, what other organs might be affected and whether lymph nodes are enlarged.

PET/CT scan: Your doctor may order a PET/CT scan as part of the evaluation for cervical cancer. This advanced nuclear imaging technique combines positron emission tomography (PET) and computed tomography (CT) into one machine. A PET/CT scan reveals information about both the structure and function of cells and tissues in the body during a single imaging session. A PET/CT scan may detect the spread of cervical cancer to nearby lymph nodes and to other organs, such as the lungs or liver.

MRI: An MRI is used to determine whether cervical cancer involves the bladder, rectum or tissues next to the cervix. Sometimes this test is ordered instead of or in addition to a CT scan. An MRI is commonly used to assess the spread of a tumor through the abdomen.

Lab tests

The main lab test for cervical cancer is advanced genomic testing of the tumor, which examines a tumor to look for DNA alterations driving the growth of cancer. By identifying the mutations that occur in a cancer cell's genome, we can better understand the tumor behavior, and we may be able to tailor your treatment based on these findings.

Physical exam and health history

Within the first two days of your arrival at one of our hospitals or outpatient care centers, we will perform a complete array of diagnostic tests, and thoroughly review your medical records and health history. Your doctor will also likely conduct a physical exam. This information helps us formulate treatment recommendations tailored to you and your needs.

Reduced wait times and comfort equipment

We understand that waiting for test results can create a great deal of stress. Our turnaround time goal—from the time of the scan to providing results so treatment planning can occur—is four hours.

We also want you to be as comfortable as possible during your imaging tests. Our team uses padding and comfort equipment, as well as a variety of positioning devices, to help you feel more relaxed during scans and procedures.

Next topic: How is cervical cancer treated?

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