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Cervical Cancer: Diagnosis and Staging

Symptoms and Detection

Cervical cancer typically develops slowly and begins with the development of precancerous changes in normal cells. Early cervical cancer has no symptoms. However, detection of abnormal cells is possible with a regular Pap smear. A regular Pap smear is also women's best opportunity for early detection of cervical cancer. As with most cancers, early detection is the best opportunity for survival.


If a Pap smear reveals abnormal cells, further diagnostic tests are performed to determine a diagnosis. Irregular cells could indicate:

  • Human Papillomavirus Infection
  • Cervical Intraepithelial Neoplasia (CIN)
  • Cervical Cancer

Further tests are necessary to make a diagnosis. Additional tests that may be performed include:

  • Colposcopy - the use of a lighted instrument to closely examine the cervix. Vinegar (acetic acid) may be swabbed on the surfaces to be examined. The acid solution makes abnormal tissues turn white and therefore they are easier to see. A camera may be attached to the instrument.
  • Biopsy - removal of a small sample of tissue for examination by a pathologist. The procedure is typically done without anesthesia and is associated with minimal pain or bleeding. It is possible to perform the biopsy during a colposcopy.

Stages of Cervical Cancer:

If the diagnostic tests indicate the presence of cancer, additional imaging (CT, MRI, etc.) may be performed to determine the location and extent of the disease. This is called staging and affects how the cancer will be treated.

  • Stage 0: The cancer is found only in the top layer of cells in the tissue that lines the cervix. Stage 0 is also called carcinoma in situ.
  • Stage I: The cancer has invaded the cervix beneath the top layer of cells. It is found only in the cervix.
  • Stage II: The cancer extends beyond the cervix into nearby tissues. It extends to the upper part of the vagina. The cancer does not invade the lower third of the vagina or thepelvic wall (the lining of the part of the body between the hips).
  • Stage III: The cancer extends to the lower part of the vagina. It also may have spread to the pelvic wall and nearby lymph nodes.
  • Stage IV: The cancer has spread to the bladderrectum, or other parts of the body.
  • Recurrent cancer: The cancer was treated, but has returned after a period of time during which it could not be detected. The cancer may show up again in the cervix or in other parts of the body.