Diagnosing and Staging Cervical Cancer

Diagnosing and Staging Cervical Cancer

Most women with cervical cancer don’t experience symptoms. They first learn that they may have cancer after getting an abnormal result on a Pap test or HPV test. Several more tests are necessary before physicians can reach a diagnosis.

At Siteman, we excel at seeing patients in a timely manner so as not to delay diagnosis and treatment. When you come to see us, your records, tests, and previous biopsies will be reviewed again by our pathologists to make sure we have the correct diagnosis.

Because Siteman is an NCI-designated Comprehensive Cancer Center, many patients travel great distances for our expertise. For patients’ convenience, we try to make visits with us as efficient as possible. This means coordinating multiple tests and appointments on the same day to minimize the number of trips and time spent traveling to one of our locations.

How is cervical cancer diagnosed?

For the majority of cervical cancer patients, the diagnostic process starts when they undergo a regularly scheduled screening exam, called a Pap test, in an ob-gyn’s office. This exam involves collecting cells from the cervix and running one or more tests on the samples to look for abnormal cells or HPV infection.

If your screening results indicate abnormal cells, you will likely be referred for a colposcopy. This is an exam in which a physician looks at the cervix using a magnifying instrument and checks for signs of pre-cancer or cancer.

If the physician identifies any areas of concern, they will perform a cervical biopsy during that same exam. A biopsy is necessary before cancer can be diagnosed. During a biopsy, a physician will remove a very small piece of tissue from your cervix so it can be examined under a microscope in a laboratory. It’s a short procedure that can be performed in your ob-gyn’s office, and results will come back typically in one week.

In some cases, your physician may opt to perform a cone biopsy, in which a larger piece of cervical tissue, roughly shaped like a cone, is removed. If a pre-cancer or even cancer is caught early and has not spread, a cone biopsy may be enough to remove all of the abnormal cells entirely. The procedure is often performed in an outpatient setting.

If you are diagnosed with cervical cancer, you may undergo imaging tests to see if the cancer has spread to other areas of your body. These might include an ultrasound, a CT scan, pelvic MRI, and a PET scan. A PET scan is a special imaging procedure that detects areas in the body that are suspicious for cancer by highlighting abnormally active cells.

Staging cervical cancer

Once cancer has been formally diagnosed, your physicians will assign it a stage. A stage is an assessment of how much the cancer has spread. Staging the cancer helps your care team develop a treatment plan for you.

Cervical cancer is staged from I to IV, with stage IV being the most advanced. At stage I, the cancer is limited to the cervix. Stage II cancers have developed beyond the uterus but not yet extended to the lower 1/3 of the vagina or to the pelvic wall. Stage III cancers have spread to the lower 1/3 of the vagina, to the pelvic sidewall or the lymph nodes around the pelvis. Stage IV cancers are more advanced and extend beyond the true pelvis.