It’s important to diagnose cervical cancer early and accurately and find out if it has spread. This helps your doctors choose the best treatment for you. At MD Anderson, specialized experts use the most modern and accurate equipment to diagnose cervical cancer. With pinpoint attention to detail, our pathologists, diagnostic radiologists and specially trained technicians find out the exact extent of disease. This helps increase the likelihood your treatment will be successful.
Cervical Cancer Diagnostic Tests
If you have symptoms or Pap test results that suggest precancerous cells or cervical cancer, your doctor will examine you and ask you questions about your health; your lifestyle, including smoking and drinking habits; and your family medical history.
One or more of the following tests may be used to find out if you have cervical cancer and if it has spread. These tests also may be used to find out if treatment is working.
Colposcopy: This test uses an instrument called a colposcope to look more closely at an area of abnormal tissue on the cervix, vagina or vulva. A colposcope is a microscope designed to examine the cervix. It looks like a pair of binoculars on a stand.
Biopsy: In a biopsy to look for cervical cancer, the doctor removes a small amount of tissue from the cervix to look at under a microscope. Types of cervical biopsies include:
Punch biopsy: The tissue sample is removed from the cervix using biopsy forceps, an instrument used to grasp tissue firmly and remove it.
Endocervical curettage (ECC): A tissue sample is scraped from an area just past the opening of the cervix using a curette (small, spoon-shaped instrument) or a thin, soft brush.
LEEP (Loop electro-surgical excision procedure): This test uses a small wire that is heated with low-voltage, high-frequency radio waves to remove cells from the cervix.
Cone biopsy: A cone-shaped sample of tissue is removed so the pathologist can see if abnormal cells are in the tissue beneath the surface of the cervix. The amount of tissue removed is larger than that removed with other types of biopsy. This type of biopsy can be done by one of the following methods:
- LEEP cone biopsy: The LEEP device is used, and the biopsy can be done in the doctor's office under local anesthesia.
- Knife cone biopsy: A scalpel (small sharp knife) is used in an operating room with local or general anesthesia.
- Laser: A carbon dioxide laser is used to remove tissue.
Cystoscopy or proctoscopy: If you are diagnosed with cervical cancer and your doctor thinks it may have spread, you may have a cytoscopy or proctoscopy or both. These tests use lighted tubes to view the inside of the bladder (cystoscopy) or the anus, rectum and lower colon (proctoscopy).
Imaging tests, which may include:
- CT or CAT (computed axial tomography) scans
- MRI (magnetic resonance imaging) scans
- PET (positron emission tomography) scans
- Chest X-ray
Laparoscopic retroperitoneal lymph node dissection: In this minimally invasive surgical procedure, lymph nodes are removed to help find if cancer has spread.
Getting a Second Opinion at MD Anderson
The pathologists at MD Anderson are highly specialized in diagnosing and staging cervical cancers, and we welcome the opportunity to provide second opinions.
Some people have an elevated risk of developing cervical cancer. Review the cervical cancer screening guidelines to see if you need to be tested.
Behavioral and lifestyle changes can help prevent cervical cancer. Visit our prevention and screening sectionto learn how to manage your risk.
In rare cases, cervical cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Visit our genetic testing page to learn more.
If you are diagnosed with cervical cancer, your doctor will determine the stage (or extent) of the disease. Staging is a way of classifying cancer by how much disease is in the body and where it has spread when it is diagnosed. This helps your doctor plan the best way to treat the cancer.
Once the staging classification is determined, it stays the same even if treatment works or the cancer spreads.
(source: National Cancer Institute)
Stage 0: Abnormal cells are found in the inner lining of the cervix. These abnormal cells may become cancer and spread to nearby normal tissue. Stage 0 also is called carcinoma in situ.
Stage I: Cancer has formed and is in the cervix only.
- Stage IA: A small amount of cancer that can be seen only with a microscope is in the tissues of the cervix.
- Stage IA1: The cancer is not more than 3 millimeters deep and not more than 7 millimeters wide.
- Stage IA2: The cancer is more than 3 but not more than 5 millimeters deep and not more than 7 millimeters wide.
- Stage IB: Cancer can be seen only with a microscope. It is more than 5 millimeters deep or 7 millimeters wide, or it can be seen
- without a microscope.
- Stage IB1: The cancer can be seen without a microscope and is not larger than 4 centimeters.
- Stage IB2: The cancer can be seen without a microscope and is larger than 4 centimeters.
Stage II: Cancer has spread beyond the cervix but not to the pelvic wall (the tissues that line the part of the body between the hips) or to the lower third of the vagina.
- Stage IIA: Cancer has spread beyond the cervix to the upper two thirds of the vagina but not to tissues around the uterus.
- Stage IIB: Cancer has spread beyond the cervix to the upper two thirds of the vagina and to the tissues around the uterus.
Stage III: Cancer has spread to the lower third of the vagina, may have spread to the pelvic wall, and/or has caused the kidney to stop working.
- Stage IIIA: Cancer has spread to the lower third of the vagina but not to the pelvic wall.
- Stage IIIB: Cancer has spread to the pelvic wall and/or the tumor has become large enough to block the ureters (the tubes that connect the kidneys to the bladder). This blockage can cause the kidneys to enlarge or stop working. Cancer cells may also have spread to lymph nodes in the pelvis.
Stage IV: Cancer has spread to the bladder, rectum or other parts of the body.
- Stage IVA: Cancer has spread to the bladder or rectal wall and may have spread to lymph nodes in the pelvis.
- Stage IVB: Cancer has spread beyond the pelvis and pelvic lymph nodes to other places in the body, such as the abdomen, liver, intestinal tract or lungs