Cervical cancer

Diagnosing cervical cancer

Women who have symptoms will usually begin by seeing their GP or practice nurse.

The GP will ask you about your general health and examine you internally with a speculum (metal or plastic instrument which opens the vagina, as used in smear tests) to identify if any lesion is visible on the cervix.

If the GP sees a lesion on your cervix they will make an urgent referral to the colposcopy clinic.

If you have suspected cervical cancer, either due to your symptoms or because your screening test has shown an abnormality, you will be referred to the nearest hospital that has a colposcopy clinic for further tests.

At the hospital the colposcopist, gynaecologist (doctor specialising in women's reproductive health) or nurse colposcopist will take your medical history before doing a physical examination. They will then carry out a colposcopy.

See questions you may want to ask the specialist.

Testing for cervical cancer

The following tests may be used when diagnosing cervical cancer:

  • colposcopy
  • large loop excision of the transformation zone (LLETZ)
  • cone biopsy.

Colposcopy

This is another examination of the cervix similar to when you have a cervical screening test. A doctor or specialist nurse uses a colposcope to look at the surface of the cervix. This is really just a large magnifying glass that they use to closely examine the skin like covering of the cervix. It doesn't go inside you.

Sometimes the doctor or specialist nurse cannot see clearly enough because the abnormal cells go further up into the cervical canal than can be seen with a colposcope. If they cannot see all the cells that are abnormal you will need to have either a LLETZ or a cone biopsy.

Large loop excision of the transformation zone (LLETZ)

In the USA, this procedure is called loop electrosurgical excision (LEEP) so you may see this term used on some websites. The area of abnormal cells is removed completely.

The following diagram shows the transformation zone on the cervix.

This diagram has been taken from Cancer Research UK's information about the cervix.

Diagram showing the transformation zone of the cervix

A LLETZ is simple and quick to carry out, works well and can be done under local anaesthetic. It also provides a clear tissue sample for the laboratory to examine.

There are quite a few other treatment options, including laser, cold coagulation and cone biopsy, and these can work equally well. The treatment page has more information on cervical cancer treatments.

You can read about two women's experiences of colposcopy and LLETZ on the Jo's Cervical Cancer Trust website:

Cone biopsy

This is a minor operation that you usually have under general anaesthetic. You will probably stay in hospital overnight.

Other tests carried out for cervical cancer

You may need further tests if you have a positive biopsy that shows cervical cancer.

The tests that you may be offered include:

  • blood tests (to find out if you are anaemic because of blood loss) 
  • chest X-ray (to find out if cancer has spread to your lungs)
  • an examination under anaesthetic (EUA) so that the doctor can see the extent of the disease.
  • other radiological tests appropriate to your symptoms.

Full details of the tests that may be done can be found at:

Questions to ask

Before you start the tests you may want to ask some questions, such as:

  • What tests are you going to do?
  • What are you looking for?
  • I might be pregnant. Can you still do the tests I need?
  • Will the tests cause any problems with pregnancy in the future?
  • What happens if I don't have the tests?
  • Will the tests show whether I have cancer?
  • Can I have all the tests as an outpatient?
  • Are any of the tests painful?
  • Who will give me the test results?
  • How long will the results take?
  • When should I contact you if I don't get the results?
  • Is there a clinical nurse specialist (CNS) I can talk to?

Getting test results

When the results of the tests are all finally done and assessed you will be called to see your consultant for the results.

Having tests then ultimately receiving a diagnosis of cancer is a frightening and often shocking experience. Many people find they struggle to take in everything that is said at their appointment, so it can be helpful to take someone with you to important appointments.

Around this time a clinical nurse specialist may take over co-ordination of your case. He or she will oversee the continuity of treatments, appointments and your best interests. They can also interpret any jargon and explain what will happen in more detail.

If you have been diagnosed with cancer and haven't been assigned a clinical nurse specialist, ask if one is available.

Last updated: 17 February 2014

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