If you've had an abnormal cervical screening test result, or any symptoms of cervical cancer, you will usually be referred for a colposcopy. This is an examination to look for abnormalities in your cervix. It's normally done by a nurse called a colposcopist.
If you have had abnormal bleeding, your GP may first recommend a chlamydia test before being referred for a colposcopy.
The colposcopist will use a device called a speculum to open your vagina, just like they do during cervical screening. A small microscope with a light at the end (a colposcope) will be used to look at your cervix. This microscope stays outside your body.
As well as examining your cervix, they may remove a small tissue sample (biopsy) so it can be checked for cancerous cells. After a biopsy, you may have some vaginal bleeding for up to 6 weeks. You may also have period-like pains.
In most cases, the abnormalities do not mean you have cervical cancer, but you may be referred to a gynaecologist for further tests.
Treatment to remove abnormal cells can sometimes be done at the same time as a colposcopy.
If the results of the colposcopy or biopsy suggest you have cervical cancer and there's a risk it may have spread, you'll probably need to have some further tests to assess how widespread the cancer is. These tests may include:
- a pelvic examination done under general anaesthetic (while you're asleep) – your womb, vagina, rectum and bladder will be checked for cancer
- blood tests – to help assess the state of your liver, kidneys and bone marrow
- a CT scan – used to help identify cancerous tumours and show whether cancerous cells have spread
- an MRI scan – also used to check whether the cancer has spread
- a chest X-ray – to check if the cancer has spread to the lungs
- a PET scan – often combined with a CT scan to see if the cancer has spread, or to check how well a person is responding to treatment
Staging is a measurement of how far the cancer has spread.
After all the tests have been completed and the results are known, it should be possible to tell what stage the cancer is. The higher the stage, the further the cancer has spread.
The staging for cervical cancer is:
- stage 0 – no cancerous cells in the cervix, but there are abnormal cells that could develop into cancer in the future – this is called pre-cancer or carcinoma in situ
- stage 1 – the cancer is only inside the cervix
- stage 2 – the cancer has spread outside the cervix into the surrounding tissue but hasn't reached the tissues lining the pelvis (pelvic wall) or the lower part of the vagina
- stage 3 – the cancer has spread into the lower section of the vagina or pelvic wall
- stage 4 – the cancer has spread into the bowel, bladder or other organs, such as the lungs