Diagnosing Cervical Cancer
Learn about the Pap test and other ways to diagnose cervical cancer.
Cervical cancer is usually caused by a virus called human papillomavirus, or HPV. HPV is spread through sexual contact. Most women who are sexually active have been exposed to HPV. Most of the time, a woman's body can fight off HPV. In some, it can cause cervical cancer.
If a Pap test shows cervical cell changes, you will likely have an HPV test to find out if you have an HPV infection. The test is done much like a Pap test. A cell sample is taken and sent to a lab to see if the HPV virus is present in the cervical cells.
Once a diagnosis of cervical dysplasia is made, it is classified according to a system. Cervical dysplasia is also called cervical intraepithelial neoplasia (CIN). It is rated as mild, moderate, or severe.
Cervical dysplasia sometimes - but not always - evolves into cervical cancer. A Pap test can catch early signs of cancer before the disease spreads deeper into the cervix and before the cancer spreads to other parts of the body.
When only some cells on the outer cervix are abnormal but do not look like cancer, they are called atypical squamous cells of undetermined significance (ASCUS). The term low-grade squamous intraepithelial lesions (LSIL) is used when the cells of the cervix are slightly abnormal but are not cancer.
Experts disagree about how and whether to treat these early abnormal cells. Some doctors will suggest a wait-and-see approach. That's because often the cell abnormalities clear up without treatment. One common option is to have follow-up Pap tests at 3 or 6 months.
Other doctors prefer a more aggressive approach. If you have abnormal Pap test results, your doctor may suggest that you have a colposcopy. This is a procedure that lets the doctor get a closer look at the cervix.
During a colposcopy the doctor may take tissue samples (cervical biopsy) to send to a lab for testing. In some cases, a larger tissue sample is needed. This test is done in the hospital under general anesthesia. The cone biopsy often removes any cancerous tissue.
What is cervical cancer staging? Cancer staging means determining the extent of the cancer, especially whether the disease has spread from one organ to another. Staging is very important because it is used to plan the best treatment. Imaging tests such as a CT scan, if necessary, as well as tissue removed and tested during a cervical biopsy are used for staging.
The stages of cervical cancer are:
Stage I. Cancer is limited to the cervix and uterus. It has not spread to nearby locations in the body. Stage II. A small amount of cancer (only visible using a microscope) has spread. The cancer has extended beyond the cervix and uterus but not to the pelvic sidewall or the lower part of the vagina. Stage III. The cancer extends to the pelvic sidewall, involves the lower third of the vagina, or obstructs one or both ureters. Stage IV. The cancer has spread to other organs in the pelvis, such as the bladder or rectum, or to distant organs such as the lungs.