Diagnosis of cervical cancer

Diagnosis of cervical cancer at the early stages

The critical factor in early detection of cervical cancer is regular gynecological examinations with a cytological analysis of cervical scraping. Visual inspection allows detecting cancer by external signs, for example, by the change in the color of the cervix.

Early diagnosis of cancer, or screening, includes a PAP test (the Papanicolaou test or Pap smear). It should be done regularly for all women aged 21 to 65 years. A mandatory PAP test is for those patients who have papillomavirus with increased oncogenic risk or have cervical dysplasia.

The material for this analysis is collected using special brushes; then the smears-prints are prepared on laboratory glass.

The Pap test cannot tell for sure if a patient has cervical cancer. An abnormal Pap test result means more testing should be done, including tests to see if cancer or a pre-cancer condition is present. The tests include colposcopy (with biopsy), endocervical scraping, and cone biopsies.

Colposcopy

Conventional methods for diagnosing cervical cancer include a colposcopy. This study, in which the colposcope visualizes the surface of the vagina and the cervix. The doctor uses a colposcope to do that. The colposcope has magnifying lenses and lets the doctor see the surface of the cervix. Colposcopy itself is usually no more uncomfortable than any other speculum exam. It can be done even during pregnancy.

When performing a colposcopy, it is possible to detect tumor and to perform a targeted biopsy of the cervix for subsequent histological examination of the tissues.

Types of biopsies for cervical cancer

A biopsy is a diagnostic method for establishing an accurate diagnosis of cancer diseases. If the biopsy of the cervix can completely remove all of the abnormal tissue, it might be the only treatment needed.

To determine the nature of changes in the cervix, the following types of biopsy are used:

Fine needle biopsy

The part of the cervix epithelium is taken with a special needle for further histological examination. The procedure is performed under local anesthesia.

Endocervical curettage (endocervical scraping)

More traumatic method. Used in cases when the transition zone between normal and abnormal cells cannot detect during colposcopy. The procedure is done with a narrow instrument (curette) under local anesthesia. It is inserted into the endocervical canal. The curette is used to scrape the inside of the canal to remove some of the tissue, which is then examined in the lab.

Cone biopsy (conization)

For this analysis a cone-shaped piece of tissue from the cervix is removed. It can be performed with 2 methods:

• the loop electrosurgical excision procedure (LEEP), also called the large loop excision of the transformation zone (done with electrically heated wire loop);
• the cold knife cone biopsy (done with a surgical scalpel or a laser).

Comprehensive examination

Diagnosis of cervical cancer is often carried out by a number of methods. In addition to a gynecological exam, a PAP test and a test for HPV, a doctor can prescribe ultrasound, MRI, CT. In some cases, PET-CT and proctoscopy may be used.

Steps of diagnosis of cervical cancer