Tests for cervical cancer

You usually have a number of tests to check for cervical cancer. This includes:

• a physical examination and blood tests

• a colposcopy

• biopsies, including a loop excision of the transformation zone (LLETZ) or cone biopsy

• a CT, MRI or PET-CT scan

Tests your GP might do

Most people with symptoms that could be due to cancer start by contacting their GP surgery. Your first appointment may be a telephone appointment. Your GP surgery then might arrange for you to go in and see a doctor or other healthcare professional.

Physical examination

Your doctor might do a physical examination, which might include examining your:

• vagina, including looking at your cervix

• pelvis (the area between the hip bones)

• rectum (back passage)

Having these examinations can feel embarrassing and distressing for some people. But remember, your doctor will do this professionally. You can stop the examination at any point if you feel overwhelmed or too uncomfortable.

Your doctor will:

• explain why you need the examination

• explain what they are going to do

• get your permission to do it

• offer you a chaperone – this will be a member of staff. A friend or relative can stay with you for comfort

• give you privacy to undress and dress and keep you covered as much as possible during the examination

Vaginal examination

You lie down on your back with your knees up and legs apart. They use a speculum to gently open your vagina. They can look at your cervix and vagina to see if there is anything abnormal. They might take a swab (sample) to check for infections, such as chlamydia.

Pelvic examination

They may also do a pelvic examination, called an internal. They put two gloved fingers into your vagina, and at the same time press down on your tummy (abdomen) with their other hand.

Rectal examination

They may also check your rectum (back passage). They can feel for any lumps or changes in size or shape. Sometimes it is not clear if your symptoms are caused by a cervical problem or a bowel problem.

Blood tests

A blood test can check your general health, including how well your liver and kidneys are working. The doctors will also check the number of blood cells.

Tests your specialist might do

Depending on the results of your examinations, your GP may refer you to a specialist at the hospital. This is usually a gynaecologist.

Your specialist usually does more tests. These include:

• a colposcopy

• biopsies, including a loop excision of the transformation zone (LLETZ), also called loop electrosurgical excision (LEEP) or loop diathermy, or a cone biopsy

• an MRI scan

• a PET-CT scan

• a chest x-ray

• a chest CT scan

• a pelvic examination under anaesthetic

Colposcopy

A colposcopy is a test to look at the cervix in detail. A colposcope is a large magnifying glass that a doctor or specialist nurse (colposcopist) uses to look closely at the skin-like covering of the cervix. By looking through it, the colposcopist can see changes that may be too small to see with the naked eye. They can take samples (biopsies) of any abnormal areas on the cervix.

You usually have a colposcopy in the hospital outpatient clinic.

Loop excision of the transformation zone (LLETZ)

LLETZ is a treatment for abnormal cervical cells that have been picked up through cervical screening. It is also used to help diagnose cervical cancer.

LLETZ stands for large loop excision of the transformation zone. It’s also known as loop electrosurgical excision (LEEP) or loop diathermy.

Your colposcopist uses a thin wire loop to remove the transformation zone of the cervix. The transformation zone is the area around the opening of the cervix. The wire has an electrical current running through it, which cuts the tissue and seals the wound at the same time.

LLETZ is an outpatient treatment and takes up to 15 minutes. You usually have it under local anaesthetic.

Cone biopsy

A cone biopsy is a small operation to remove a cone shaped piece of tissue from your cervix.

You usually have it under general anaesthetic, which means you are asleep. The operation takes about 15 minutes. You will probably stay in hospital overnight.

You might have a cone biopsy if you have symptoms that could be caused by cervical cancer. It helps your doctor to diagnose cervical cancer.

It's also a treatment for abnormal cervical cells picked up through cervical screening.

MRI scan

An MRI is a scan that creates pictures using magnetism and radio waves. MRI scans produce pictures from angles all around the body and clearly show soft tissues. MRI stands for magnetic resonance imaging.

Doctors use an MRI scan to help stage your cervical cancer.

PET-CT scan

A PET-CT scan combines a CT scan and a PET scan. It gives detailed information about your cancer.

The CT scan takes a series of x-rays from all around your body and puts them together to create a 3 dimensional (3D) picture.

The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal.

You usually have a PET-CT scan in the radiology department as an outpatient. A radiographer operates the scanner. It usually takes between 30 and 60 minutes.

You might have a PET-CT scan to check whether cervical cancer has spread to your lymph nodes.

PET-MRI scan

A PET-MRI scan combines a PET scan and an MRI scan. It gives detailed information about your cancer.

The PET scan uses a mildly radioactive drug to show up areas of your body where cells are more active than normal.

MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to create cross section pictures of the body. It shows up soft tissues very clearly.

Chest x-ray

An x-ray is a test that uses small amounts (doses) of radiation to take pictures of the inside of your body. They are a good way to look at bones and show changes caused by cancer or other medical conditions. X-rays can also show changes in other organs, such as the lungs.

You usually have x-rays in the hospital's imaging department taken by a radiographer. But in an emergency, they are sometimes done on the ward.

You might have an x-ray to check whether your cervical cancer has spread to the lungs.

CT scan

A CT scan is a test that uses x-rays and a computer to create detailed pictures of the inside of your body. It takes pictures from different angles. The computer puts them together to make a 3 dimensional (3D) image.

You might have a CT scan to check whether your cervical cancer has spread outside the cervix.

Pelvic examination under anaesthetic

This is an internal examination under general anaesthetic. The test is to check for signs of cancer spread around your cervix. An examination under general anaesthetic is also called an EUA.

The examination includes checking your:

• cervix and vagina
• womb
• bladder
• back passage (rectum)

Your doctor (gynaecological oncologist) can take samples of tissue (biopsies) during the test if necessary.

Treatment

The tests you have helps your doctor find out if you have cervical cancer and how far it has grown. This is the stage of the cancer.

This is important because doctors recommend your treatment according to the stage of the cancer.

Coping with cervical cancer

Coping with a diagnosis of cervical cancer can be difficult. There is help and support available to help you and your family.