Diagnosing Cervical Cancer

Regular cervical screening can help detect cervical cancer and precancerous cells that may one day develop into cervical cancer.

The American Cancer Society encourages women to begin cervical cancer screening at age 21, which includes:

  • Pap test every 3 years for women 21-29 years of age. HPV testing is not recommended unless there are abnormal Pap results.
  • Pap test and HPV test (co-testing) every 5 years for women 30-65 years of age. It also is acceptable to have a Pap test alone every 3 years.
  • Women age 65 or older who have had regular screening within the last 10 years and no serious pre-cancers within the last 20 years no longer need to be screened.
  • Women who have had a total hysterectomy do not need screenings unless the surgery was performed as a treatment for cervical pre-cancer or cancer.

A Pap test (sometimes called Pap smear or cervical smear) is commonly used to screen for cervical cancer. Pap tests (which may be combined with a test for human papillomavirus or HPV) can find abnormal cells or cervical cancer. They can also help find cancer early when treatment is more likely to be effective.

The Pap test is not painful for most women. During a pelvic exam, a piece of cotton, a brush, or a small wooden stick is gently used to scrape cells from the cervix and vagina. The cells are then viewed under a microscope to find out if they are abnormal. Typically, abnormal cells found by a Pap test are not cancerous. The same sample of cells may also be tested for HPV infection.

If you have abnormal Pap or HPV test results, your doctor will suggest other tests to make a diagnosis:

  • Colposcopy: The doctor uses a colposcope to look at the cervix. The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor's office or clinic.
  • Biopsy: Most women have the tissue removed in the doctor's office with local anesthesia. A pathologist checks the tissue under a microscope for abnormal cells.
  • Punch biopsy: The doctor uses a sharp tool to pinch off small samples of cervical tissue.
  • LEEP: The doctor uses an electric wire loop to slice off a thin, round piece of cervical tissue.
  • Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervix. Some doctors may use a thin, soft brush instead of a curette.

When the tissue is removed from the cervix this may cause some bleeding or other discharge. The area usually heals quickly. Some women also feel some pain similar to menstrual cramps. Your doctor can suggest medicine that will help relieve your pain.

Women with abnormal cervical cells only on the surface may want to read the NCI booklet Understanding Cervical Changes: A Health Guide for Women. It tells about abnormal cells and describes treatments.