HPV testing
Most people with cervical cancer are identified through HPV testing during cervical screening. They don’t usually have any symptoms and are found to have very early cervical cancer – which is easier to treat and less likely to cause long-term problems.
If high risk HPV is detected in your vaginal swab at cervical screening, you'll need a follow-up check. Depending on the type of HPV detected, you might need a cervical sample test (a smear test) or you might need a referral to a specialist for a colposcopy.
Cervical sample test
If high risk HPV infection is found through your cervical screening test, or if you have symptoms that suggest you may have cervical cancer, your healthcare provider will examine you (this may include vaginal, pelvic and rectal exams) and take a cervical sample (used to be known as a smear test).
In a cervical sample test, some of the cells from the surface of the cervix are taken and examined under a microscope to look for abnormal cells. HPV testing will also be done if you haven’t had a screening test. Read more about these tests on the cervical screening page.
Colposcopy and biopsy
If abnormal cells are found in your cervical sample test, you may be referred to a specialist doctor (usually a gynaecologist or an oncologist). This doesn’t necessarily mean there is cancer present – for a cancer to be present the abnormal cells must start to grow into (invade) the cervix.
A specialist doctor will do a colposcopy which involves looking at your cervix using a magnifying device called a colposcope. If necessary, they’ll take a small piece of tissue (a cervical biopsy) from any areas that look abnormal. The tissue sample will be examined under a microscope to look for cancer.
LLETZ, cone biopsy
LLETZ (Large Loop Excision of the Transformation Zone) is a procedure that removes abnormal cells from your cervix. The small pieces of tissue that are removed are sent to the laboratory to test for cancer.
A cone biopsy is where a small cone-shaped part of your cervix that contains the abnormal cells is removed. The cells are sent to the lab for testing.
LLETZ and cone biopsy can also be used for the treatment of non-invasive or very early stage cervical cancer (see the treatment section below).
MRI, CT and PET scans
If the results of the tests above suggest that you may have cervical cancer and that there's a risk the cancer may have spread, further tests are done to find out how widespread the cancer is (what stage it is). This makes it possible to plan the best treatment. The most common tests are:
- MRI scan – this is the best way of seeing how far the main part of the cancer has spread through the cervix and how close it is to the bladder and the bowel.
- CT scan – this scan is very good for looking at lymph nodes in your pelvis and chest which is where the cancer is most likely to spread to first.
- PET scan – this is often combined with CT scanning to give more detailed information about your cancer.