How cervical cancer is diagnosed

Colposcopy Back to top

 

If abnormal cells are found in the smear test, you will be referred for a colposcopy to have a biopsy taken. This is usually done in a hospital outpatient clinic. Some hospitals don’t have the facilities for colposcopy and you may have to visit a more specialised hospital in your area.

A colposcope is like a small microscope with a light and allows the nurse or doctor to make a thorough examination of the abnormal cells on the cervix.

Before your test you’ll be helped to position yourself on the couch. In the same way as when you had the screening test, the nurse or doctor will use a speculum to hold the vagina open. The doctor or nurse may repeat the screening test. A liquid is then dabbed onto the cervix to make the abnormal areas show up more clearly. A light is shone onto the cervix and the nurse or doctor looks through the colposcope to examine the area in detail.

A small sample of surface cells (a biopsy) will be taken from the cervix and examined under a microscope by a pathologist. This can be uncomfortable and may cause a feeling like a period pain, but the test only takes a few minutes. You may have some slight bleeding for a few days afterwards.

Large loop excision of the transformation zone (LLETZ) Back to top

Abnormal cells are most likely to develop in an area of the cervix known as the transformation zone. LLETZ is a common procedure which removes the abnormal cells in the transformation zone. Before the procedure a local anaesthetic is usually given. A thin wire is then used to cut away the affected area.

The procedure may feel uncomfortable and it’s usual to have slight bleeding or discharge for a few days after this treatment. You may be asked not to use tampons or have sex for a month afterwards.

Cone biopsy Back to top

If the abnormal area can’t be seen properly with the colposcope, you may have a cone biopsy. This is done under a general anaesthetic, and you may need an overnight stay in hospital.

 

A small cone-shaped section of the cervix, which is large enough to contain the abnormal cells, is removed for examination under a microscope by a pathologist.

Various methods can be used to do this. If there is just a very small growth of cancer cells (microinvasive cancer), the cone biopsy may remove it all so that no further treatment is needed. Even if the cone biopsy has not removed all of the cancer cells, it’s still helpful for your diagnosis, as it will help the doctors to decide on the right type of treatment for you.

After the cone biopsy a gauze pack, like a tampon, may be placed in your vagina to prevent bleeding. This is usually removed within 24 hours. You may also have a thin tube, called a catheter, put into your bladder so that you can pass urine while the vaginal pack is in place. It’s normal to have some light bleeding for a few days after a cone biopsy. Strenuous physical activity and sex should be avoided for 4–6 weeks to allow the cervix to heal.

 

It may take some time for you to get the results of the cone biopsy. You could ask your gynaecologist about when and how you will be given any further news about the need for more treatment or tests. It’s a difficult time for most women and you may need support from family, friends or support organisations| , while you are waiting for your results.