Followup Testing

If the results of your Pap test suggest abnormal cells, your doctor will want to refer you to a specialist for more tests, including the following:

Colposcopy is an in-office examination. The cervix is viewed through an instrument called a colposcope. If there are abnormal cells on the cervix, a biopsy will be done.

Biopsy is the removal of a sample of tissue to see whether cancer cells are present. It is the only way to find out whether cells show dysplasia, cancer or neither.

If Cancer Is Found

If your biopsy shows that you have cancer, your doctor may refer you to a specialist in gynecologic cancer. After a careful pelvic examination, which might be done under a general anesthetic, you may need to have more tests and imaging to determine if the cancer has spread locally or to other organs. Your doctor may recommend one of the following:

Cystoscopy tests whether the cancer has spread to the bladder. The doctor examines the inside of the bladder using a lighted tube. This test is rarely done on patients with early cervical cancer.

Sigmoidoscopy is used to see if the cancer has spread to the rectum or the lower part of the colon.

Chest x-rays may be performed to see if the cancer has spread to the lungs.

Imaging tests may also be used to see whether the cancer has spread to other parts of the body. These tests allow doctors to see into the soft tissues of the body without surgery. These imaging tests include:

• CT (computed tomography) scans – a computer is used to compile multiple x-ray images into a more complete cross-section of the body.
• MRI (magnetic resonance imaging) – magnetic waves are used to create an image of the body.
• IVP (intravenous pyelogram) – a dye is injected into a vein in your arm, to highlight the urinary tract, then a series of x-rays is taken. Since CT scans have replaced this test in most places in Canada, IVP is performed very rarely.

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