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Cervical Cancer Detection and Diagnosis

Symptoms of cervical cancer may include unusual vaginal discharge or bleeding, or pain or bleeding during intercourse. But often there are no signs or symptoms of cervical cancer until it has spread to other tissue. An annual Pap test is essential to finding cervical cancer early.

Early Detection of Cervical Cancer

If a Pap test shows abnormal cells, the following tests may be performed:

• Colposcopy: a special viewing scope with magnifying lenses is used to examine the surface of your cervix.
• Cervical biopsy: a thin, flexible tube is inserted through the vagina into the uterus to remove a sample of cells from the lining of the uterus. The cells are then examined under a microscope for signs of cancerous changes.
• Colposcopic biopsy: while viewing your cervix with a colposcope, the physician removes a tiny portion of abnormal tissue from the surface of the cervix with a special tweezers. The cells are then examined under a microscope.
• Endocervical curettage:often performed at the same time as a colposcopic biopsy, this procedure uses an instrument to scrape cells for further testing from the canal joining the cervix and uterus.
• Cone biopsy:a cone-shaped piece of tissue is removed from your cervix for further examination with either a heated, thin wire loop (known as a LEEP or LLETZ procedure); or a "cold knife"-a surgical scalpel or laser. Sometimes a cone biopsy also serves as a treatment to remove pre-cancers or early cancers.

Diagnostics

In addition to the biopsies used for early detection, diagnostic equipment may be used to see if the cancer has spread. This may include:

• Intravenous urography: also known as intravenous pyelography (IVP), a contrast "dye" is injected into a vein to highlight the urinary system for viewing on X-ray.
• Cystoscopy or proctoscopy: to check to see if cancer has spread to the urethra or bladder, a thin, lighted tube (cystoscope) is inserted through your urethra. Similarly, a proctoscope is inserted into your rectum to check for cancer there. 
• Computed tomography scan (CT): combines multiple X-rays to provide three-dimensional clarity and show various types of tissue, including blood vessels. CT not only confirms the presence of a tumor, but can show its precise location, size and involvement with adjacent tissue.
• Magnetic resonance imaging (MRI): magnets and radio waves provide three-dimensional body images.. Used to view biochemical changes in your body, MRI imaging detects cancerous tumors, particularly those that have spread outside your cervix. It may also be used to determine if a tumor is benign or malignant.
• Positron emission tomography scan (PET): aspecific dye injected into a vein highlights cancer cells growing anywhere in your body that can then be detected by a special camera.