Women's Health Matters

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Diagnosing Cervical Cancer

Dysplasia or cancer of the cervix often has no signs or symptoms.

Symptoms usually only appear when the cancer is further along. Most women with cancer of the cervix have no warning symptoms and the cancer is detected through a routine checkup and pelvic exam; however, any of the following signs or symptoms should be reported to your doctor immediately:

  • pain in the lower abdomen, pelvis or back
  • spotting between periods
  • bloody or watery discharge from the vagina
  • irregular bleeding
  • bleeding during or after intercourse
  • pain during sexual intercourse

Note: These symptoms are also associated with other conditions and do not necessarily mean that you have cancer. Check with your doctor.

Cancerous and pre-cancerous changes in the cervix are most often detected using a Pap smear. This examination is done in your doctor's office. All women should have regular Pap smears starting at the age of 18 or when they become sexually active. Many doctors believe that even virginal women should begin regular Pap tests at the age of 18. Women who have had a hysterectomy (surgical removal of the uterus) and those past menopause still need to have regular Pap tests. Women who have had four normal Pap tests in the previous ten years may discontinue Pap tests at the age of 70.

Pap smears should not be used to test for cervical cancer if a woman has symptoms of bleeding and/or discharge. The purpose of the Pap test is to detect abnormal cells before they go on to become cancer or to detect early cancer before symptoms develop. This is why routine Pap smears are so important.

Follow-up Testing

If the results of your Pap test suggest abnormal cells, your doctor will want to refer you to a specialist for more tests, including the following:

  • Colposcopy is an in-office examination. The cervix is viewed through an instrument called a colposcope. If there are abnormal cells on the cervix, a biopsy will be done.
  • Biopsy is the removal of a sample of tissue to see whether cancer cells are present. It is the only way to find out whether cells show dysplasia, cancer or neither.

If Cancer Is Found

If your biopsy shows that you have cancer, your doctor may refer you to a specialist in gynecologic cancer. After a careful pelvic examination, which might be done under a general anesthetic, you may need to have more tests and imaging to determine if the cancer has spread locally or to other organs. Your doctor may recommend one of the following:

Cystoscopy tests whether the cancer has spread to the bladder. The doctor examines the inside of the bladder using a lighted tube. This test is rarely done on patients with early cervical cancer.

Sigmoidoscopy is used to see if the cancer has spread to the rectum or the lower part of the colon.

Chest x-rays
Chest x-rays may be performed to see if the cancer has spread to the lungs.

Imaging tests
Imaging tests may also be used to see whether the cancer has spread to other parts of the body. These tests allow doctors to see into the soft tissues of the body without surgery. These imaging tests include:

  • CT (computed tomography) scans – a computer is used to compile multiple x-ray images into a more complete cross-section of the body.
  • MRI (magnetic resonance imaging) – magnetic waves are used to create an image of the body.
  • IVP (intravenous pyelogram) – a dye is injected into a vein in your arm, to highlight the urinary tract, then a series of x-rays is taken. Since CT scans have replaced this test in most places in Canada, IVP is performed very rarely.


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  • A publication of:
  • Women's College Hospital