When you have an unclear Pap test result and a positive HPV test, your doctor will examine your cervix closely for abnormal cells. Any that are found will be removed or monitored to make sure they don’t progress to cancer, and you should be retested with Pap and HPV tests in one year. Be aware it can take a year or more before your doctor can tell if HPV will go away or cause abnormal cell changes.
Your doctor will also take a closer look at your cervix if your HPV test is positive and your Pap test is abnormal. Depending on how serious the cell changes are on your cervix, your doctor may need to remove the abnormal cells so they don’t result in cancerous changes over time.
If test results of your abnormal Pap test are suggestive of a malignancy or show precancerous cells -— or if you have symptoms such as abnormal bleeding and pelvic pain that could indicate cancer -— you’ll be scheduled for additional exams and tests for cervical cancer.
Diagnostic tests for cervical cancer
- Colposcopy. Your doctor will use a speculum to view your cervix with a colposcope, an instrument that stays outside the body and has magnifying lenses, allowing your doctor to examine your cervix very closely and in detail. This test is typically no more uncomfortable than a regular pelvic exam, the American Cancer Society points out. A weak solution of an acid similar to vinegar will be applied to your cervix because it makes abnormal areas more visible so the doctor can biopsy these places to test for cancer cells. The biopsy may cause some cramping, bleeding, mild discomfort, or some pain, depending on the individual patient. A local anesthetic can be applied to numb the cervix before the biopsy. The tissue is sent to a lab for examination.
- Endocervical curettage (also known as endocervical scraping). Sometimes the area at risk for HPV infection and precancerous cells, the endocervical canal (part of the cervix closest to the uterus), can’t be visualized clearly enough with a colposcope so endocervical curettage is used. For this test, a sample of abnormal tissue is removed using a small, spoon-shaped instrument called a curette to scrape the inside of the endocervical canal. The tissue is examined in a lab for signs of cancer.
- Cone biopsy. This procedure uses a scalpel, a laser knife, or a thin wire loop heated by an electric current to remove a cone-shaped piece of abnormal tissue from an area of the cervix that needs to be checked for cervical cancer. This form of biopsy, also called conization, is not only used to diagnose pre-cancers and cancers but can also be used as a treatment because it sometimes is able to completely remove precancerous cells and very early-stage cancers. With both endocervical curettage and cone biopsy, mild cramping and some bleeding may occur for a few weeks after the procedures.
January 08, 2018
Janet O’Dell, RN