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Diagnosis Staging Cervical Cancer Diagnosis Doctors generally agree that a step-by-step approach to diagnosis is preferable to immediate aggressive treatment. This limits the impact on the cervix as much as possible, especially before a complete biopsy has been performed. Continued or prolonged invasive treatments can erode and weaken the cervix. Colposcopy During this procedure, your physician uses a speculum and viewing scope (colposcope) to look into the vagina and magnify the region for inspection. For this procedure, a Schiller test, a rinse of acetic acid solution applied with a cotton swab, is administered to turn abnormal areas yellow or white. Small portions of these abnormal areas can then be removed for biopsy with a special instrument. A colposcopy can be performed in your doctor's office and takes about 15 minutes. Although the procedure may be uncomfortable, it is not painful. You may feel some discomfort, similar to menstrual cramps, when cervical tissue is removed for biopsy. Endocervical curettage (ECC) Often performed during a colposcopy, ECC involves scraping cells from the canal of the cervix. While the outside of the cervix can be seen easily using a colposcope, the lining of the endocervical canal cannot be viewed. Adenocarcinoma, which tends to form in the cervical canal, is difficult to detect without an ECC. Adenocarcinoma is more common in young women and spreads quickly. Together, colposcopy and ECC can reliably identify most cervical cancers. Loop electrocautery excision procedure (LEEP) and conization These two more extensive methods of diagnosing abnormal tissue may also be used as treatments for CIN and early invasive cervical cancer. With LEEP, abnormal or suspicious cervical tissue is removed with a heated wire loop that cauterizes tissue as it is being used. This can stop any bleeding and help eliminate remaining abnormal tissue. With conization, a cone-shaped section of the cervix is removed with a scalpel or a laser. This procedure requires anesthesia and usually is performed as outpatient surgery in the hospital. Most doctors suggest conization only when other diagnostic tests have revealed cancerous abnormalities. Conization helps to assess how much tissue is diseased. Because it requires removal of part of the cervix, it should be recommended only when invasive cervical cancer is suspected and a comprehensive diagnosis is necessary, and only after biopsies from other tests have indicated severe abnormalities. Staging Cervical Cancer The decision about how to treat any invasive cancer is based on how deeply the tumor has grown into the tissue and how much it has spread or metastasized. A classification system, called staging, is used to describe how far cancer has spread. The table below shows the five stages and the rates of survival after treatment for each stage. Unlike some other types of cancers, cervical cancer stages are clinical, in other words, surgery is not a part of the staging process. Staging involves a thorough physical exam, colposcopy, biopsies (including a cone biopsy), and limited imaging studies such as a chest x-ray, an intravenous pyelography (IVP - a test used to see if there are any abnormality of the urine flow from the kidneys to the bladder), and a barium enema. Special scopes may be used to evaluate the bladder and the lower portion of the bowel including the rectum.
 This content is reviewed regularly. Last Updated 10/2/2009
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