Symptoms and signs
Precancerous changes and early cancers of the cervix generally do not cause pain or other
symptoms. It is important not to wait to feel pain before seeing a doctor. When the disease gets
worse, women may notice one or more of these symptoms:
- Abnormal vaginal bleeding
- Bleeding that occurs between regular menstrual periods
- Bleeding after sexual intercourse, douching, or a pelvic exam
- Menstrual periods that last longer and are heavier than before
- Bleeding after menopause
- Increased vaginal discharge
- Pelvic pain
- Pain during sexual intercourse
Infections or other health problems may also cause these symptoms, and only a doctor can tell
for sure. A woman with any of these symptoms should tell her doctor so that problems can be
diagnosed and treated as early as possible.
Detection
If a woman has a symptom or Pap test results that suggest precancerous cells or cancer of the
cervix, her doctor will suggest other procedures to make a diagnosis. These may include:
- Colposcopy: The doctor uses a colposcope to look at the cervix. The colposcope combines a bright light with a magnifying lens to make tissue easier to see. It is not inserted into the vagina. A colposcopy is usually done in the doctor's office or clinic.
- Biopsy: The doctor removes tissue to look for precancerous cells or cancer cells. Most women have their biopsy in the doctor's office with local anesthesia. A pathologist checks the tissue with a microscope.
- Punch biopsy: The doctor uses a sharp, hollow device to pinch off small samples of cervical tissue.
- LEEP: The doctor uses an electric wire loop to slice off a thin, round piece of tissue.
- Endocervical curettage: The doctor uses a curette (a small, spoon-shaped instrument) to scrape a small sample of tissue from the cervical canal. Some doctors may use a thin, soft brush instead of a curette.
- Conization: The doctor removes a cone-shaped sample of tissue. A conization, or cone biopsy, lets the pathologist see if abnormal cells are in the tissue beneath the surface of the cervix. The doctor may do this test in the hospital under general anesthesia. Conization also may be used to remove a precancerous area.
You may want to ask your doctor these questions before having a procedure:
- Which test(s) do you recommend?
- How will the test be done?
- Will I have to go to the hospital?
- How long will it take? Will I be awake? Will it hurt?
- Are there any risks? What are the chances of infection or bleeding after the procedure?
- Can the test affect my ability to get pregnant and have children?
- How soon will I know the results? Who will explain them to me?
- If I do have cancer, who will talk to me about the next steps? When?
For the past several decades, the number of women diagnosed each year with cervical cancer has
been falling. Doctors believe this is mainly because of the success of screening, and recommend
that women help reduce their risk of cervical cancer by having regular Pap tests. This is
especially important for women at higher-than-average risk of cervical cancer.
Most often, abnormal cells found by a Pap test are not cancerous. However, some abnormal
conditions may become cancer over time:
- LSIL (low-grade squamous intraepithelial lesion): LSILs are mild cell changes on the surface of the cervix, often caused by HPV infections. LSILs are common, especially in young women. LSILs are not cancer. Even without treatment, most LSILs stay the same or go away. However, some turn into high-grade lesions, which may lead to cancer.
-
HSIL (high-grade squamous intraepithelial lesion): HSILs
are not cancer, but without treatment they may lead to cancer. The precancerous cells are only on
the surface of the cervix. They look very different from normal cells.
You may want to ask the doctor the following questions about screening:
- How soon after the test will I learn the results?
- Do you recommend that I get tested for HPV?
- How much do the tests cost? Will my health insurance help pay for screening tests?