Cervical Cancer

Diagnosis

The role of the Pap smear is to screen for cervical cancers and cervical pre-cancers. In its early stages, cervical cancer usually has no symptoms.

To diagnose cervical cancer, your doctor first performs the following procedures:

• Pap smear. In this test, your doctor collects cells from your cervix during a vaginal exam to look for abnormal, or precancerous, changes in the lining of your cervix
• Colposcopy. If the Pap smear results are abnormal, your doctor may check your cervix using a magnifying lens (colposcopy) and collect and examine cells (biopsy) to determine whether cancer is present.

If the exams reveal precancerous changes in cells, such as abnormal tissue growth or carcinoma in situ, your doctor may remove tissue or treat the area using a laser. If the exams show invasive cancer, your doctor will order more tests to determine the extent of your cancer. These tests might include:

• Physical exam. This exam involves the rectum and anus.
• Cystoscopy. Your doctor examines your bladder using a lighted scope.
• Rectosigmoidoscopy. Your doctor visually inspects your rectum to determine if cancer is present.
• Positron emission tomography (PET) scan. This scan can detect the spread of cancer beyond your cervix or to nearby lymph nodes.
• Computed tomography (CT) scan. A CT scan can show whether your cancer has spread.
• Pyelogram. Your doctor injects a special dye into your vein and takes an X-ray of your urinary system.
• A chest X-ray.
• Blood tests.

Based on the doctor's evaluation, your cancer will be classified into one of more than 10 substages. Staging helps your doctor determine what treatments may be more effective. In general, stages for cervical cancer include:

• Stage 0 or carcinoma in situ. Stage 0 cancer is preinvasive cancer, and abnormal cells appear only in the first layer of cells that line the cervix.
• Stage I. Stage I cancer is confined to the cervix. Your doctor may further classify it as Stages IA1, IA2, IB1 or IB2 depending on the size of the tumor and how deeply the cancer has invaded.
• Stage II. Stage II cancer has spread beyond the uterus, but not to the pelvic sidewall or the upper third of the vagina. Your doctor may classify it as Stage IIA or IIB.
• Stage III. In Stage III, your cancer extends to your pelvic wall or the lower third of your vagina or causes expansion of your ureters, resulting in kidney problems. Your doctor may classify it as Stage IIIA or IIIB based on whether cancer cells have extended to the sidewall of your pelvis.
• Stage IV. In Stage IV, the cancer has invaded your bladder or rectum and may extend beyond your pelvis. Your doctor may identify it as Stage IVA or IVB.

Read more about Pap smear, colposcopy, cystoscopy, PET scan, CT scan and chest X-ray at www.MayoClinic.com.