Virginia Commonwealth University

VCU Massey Cancer Center

Diagnosis and staging

How is cervical cancer diagnosed?

When cervical problems are found during a pelvic examination, or abnormal cells are found through a Pap test, a cervical biopsy may be performed. A biopsy is a procedure in which tissue samples are removed from the body for examination under a microscope to determine if cancer or other abnormal cells are present. The diagnosis of cancer is confirmed only by a biopsy.

There are several types of procedure that may be used to diagnose cervical cancer. Some of these procedures completely remove areas of abnormal tissue and may be used for treatment of precancerous lesions. Some biopsy procedures only require local anesthesia, while others require a general anesthesia. These procedures include:

  • Colposcopy – a procedure that uses an instrument with magnifying lenses, called a colposcope, to examine the cervix for abnormalities. If abnormal tissue is found, a biopsy is usually performed (colposcopic biopsy).
  • Endocervical curettage – a procedure that uses a narrow instrument called a curette to scrape the lining of the endocervical canal. This type of biopsy is usually completed along with the colposcopic biopsy.
  • Loop electrosurgical excision procedure – a procedure that uses an electric wire loop to obtain a piece of tissue.
  • Cone biopsy (also called conization) – a biopsy in which a larger cone-shaped piece of tissue is removed from the cervix by using the loop electrosurgical excision procedure or the cold knife cone biopsy procedure. The cone biopsy procedure may be used as a treatment for precancerous lesions and early cancers.
  • Cystoscopy – using a lighted telescope to look in the bladder.
  • Proctoscopy – using a proctoscope to look in the rectum to assess for spread of the disease.

 

Cervical cancer staging

Cervical cancer staging is based primarily on physical exam findings and simple diagnostic tests.

 

Stage I

The cancer is confined to the cervix.

Stage II

The cancer has spread to the upper vagina or supporting tissues of the cervix.

Stage III

The cancer has spread to the lower vagina or the sides of the pelvis, or a kidney is blocked (obstructed) by the cancer.

Stage IV

The cancer has spread into the bladder or rectum outside the pelvic organs such as the liver or lung.