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How is cervical cancer diagnosed and assessed?

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To confirm the diagnosis

A doctor will usually do a vaginal examination if you have symptoms which may possibly be cervical cancer. He or she may feel an abnormal cervix. If cervical cancer is suspected, you will usually be referred for colposcopy.

Colposcopy is a more detailed examination of the cervix. For this test a speculum is gently put into the vagina so the cervix can be seen. The doctor uses a magnifier (colposcope) to look at the cervix in more detail. The test takes about 15 minutes. During colposcopy it is usual to take a small piece of tissue from the cervix (biopsy). The biopsy sample is then examined under a microscope to look for cancer cells.

Assessing the extent and spread

If you are found to have cervical cancer then further tests may be advised to assess if the cancer has spread. For example, a CT scan, an MRI scan, a chest x-ray, an ultrasound scan, blood tests, an examination under anaesthetic of the uterus, bladder or rectum, or other tests. (There are separate leaflets which describe most of these tests in more detail.) This assessment is called 'staging' of the cancer. The aim of staging is to find out:

How much the tumour has grown, and whether it has grown to other nearby structures such as the bladder or rectum.
Whether the cancer has spread to local lymph glands (nodes).
Whether the cancer has spread to other areas of the body (metastasised).

Exactly what tests are needed depends on the initial assessment, and the results of the biopsy.

For example, the biopsy may show that the cancer is at a very early stage and remains just in the surface cells of the cervix. This is unlikely to have spread (metastasised) and you may not need many other tests. However, if the cancer appears to be more advanced and likely to have spread then a range of tests may be needed.

Finding out the stage of the cancer helps doctors to advise on the best treatment options. It also gives a reasonable indication of outlook (prognosis). See separate leaflet called 'Cancer Staging and Grading' for details.