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Cervical cancer

Diagnosing cervical cancer

Page last updated: January 2024

The information on this webpage was adapted from Understanding Cervical Cancer - A guide for people with cancer, their families and friends (2023 edition). This webpage was last updated in January 2024.

Expert content reviewers:

This information was developed based on international and Australian clinical practice guidelines, and with the help of a range of health professionals and people affected by cervical cancer:

  • Prof Martin Oehler, Director of Gynaecological Oncology, Royal Adelaide Hospital, and Clinical Professor, University of Adelaide, SA
  • Dawn Bedwell, 13 11 20 Consultant, Cancer Council QLD
  • Gemma Busuttil, Radiation Therapist, Crown Princess Mary Cancer Centre, Westmead Hospital, NSW
  • Dr Antonia Jones, Gynaecological Oncologist, The Royal Women’s Hospital and Mercy Hospital for Women, VIC
  • Angela Keating, Senior Psychologist, Royal Hospital for Women, NSW
  • Anne Mellon, Clinical Nurse Consultant – Gynaecological Oncology, Hunter New England Centre for Gynaecological Cancer, NSW
  • Dr Inger Olesen, Medical Oncologist, Andrew Love Cancer Centre, Barwon Health, Geelong, VIC
  • Dr Serena Sia, Radiation Oncologist, Fiona Stanley Hospital and King Edward Memorial Hospital, WA
  • A/Prof Megan Smith, Co-lead, Cervical Cancer and HPV Stream, The Daffodil Centre, Cancer Council NSW and The University of Sydney, NSW
  • Emily Stevens, Gynaecology Oncology Nurse Coordinator, Southern Adelaide Local Health Network, Flinders Medical Centre, SA
  • Melissa Whalen, Consumer.

If you have symptoms or your cervical screening test results suggest that you have a higher risk of developing cervical cancer, you will usually have more tests. 

Some tests allow your doctor to see the tissue in your cervix and surrounding areas more clearly, while others tell the doctor about your general health and whether the cancer has spread. 

No one can predict the exact course of the disease, however your prognosis can give you an idea about the general outlook.

Colposcopy and biopsy

A colposcopy is a way of looking closely at the cervix and vagina to see if there are any abnormal or changed cells. It takes about 10–15 minutes and involves a colposcope, which is a microscope with a light, being placed near your vulva. 

If the colposcopist sees any suspicious-looking areas, they will usually take a tissue sample (biopsy) from the surface of the cervix . You will be able to go home once the colposcopy and biopsy are done. The results are usually available in about a week.

After the procedure, it is common to have cramping that feels similar to menstrual pain. You may also have some light bleeding or other vaginal discharge for up to a week.

You will probably be advised not to have sexual intercourse or use tampons for a certain amount of time after the procedure. 

“My doctor said that because I had regular cervical screening tests, the cancer was picked up while it was small.” KAREN

The Cervical Screening Test

Cervical cancer is one of the most preventable cancers and can be successfully treated if detected early.

The Cervical Screening Test is the best way to protect against cervical cancer.

Learn more

Treating precancerous cell changes

If any of the tests show precancerous cell changes, you may have one of the following procedures to remove the area of abnormal cells and prevent it developing cervical cancer. 

Large loop excision of the transformation zone (LLETZ)

Also called loop electrosurgical excision procedure (LEEP), this is the most common way of treating precancerous changes of the cervix. The abnormal tissue is removed using a thin wire loop that is heated electrically.

The aim is to remove all the abnormal cells from the surface of the cervix and it's done under local anaesthetic in your doctor’s clinic or under local or general anaesthetic in hospital. A LLETZ takes about 5–10 minutes and results are usually available in 1–2 weeks.

You may have some vaginal bleeding and cramping after the procedure. These side effects will usually ease in a few days, but you may notice some spotting for several weeks.

If the bleeding lasts longer than 3–4 weeks, becomes heavy, has an unpleasant smell or you develop fever or intense pelvic pain, see your doctor.

You should not have sexual intercourse or use tampons for 4–6 weeks after the procedure. You will also need to avoid baths, swimming pools and spas.

After a LLETZ or LEEP you can still become pregnant, but you may have a slightly higher risk of having the baby prematurely. Talk to your doctor before the procedure if you are concerned. 

Cone biopsy

This procedure is used when abnormal cells are found in the cervical canal, if a larger area needs to be removed or when early-stage cancer is suspected.

In some cases, a cone biopsy is also used to treat very early-stage cancers, particularly if you would like to have children in the future.

A cone biopsy is usually done as day surgery in hospital under general anaesthetic. A surgical knife (scalpel) is used to remove a cone-shaped piece of tissue from the cervix, which is examined to make sure all the abnormal cells have been removed.

Results are usually available within a week. After a cone biopsy, you may have some light bleeding or cramping for a few days. Avoid doing any heavy lifting for a few weeks.

If the bleeding lasts longer than 3–4 weeks, becomes heavy, has an unpleasant smell, or you develop a fever or intense pelvic pain, see your doctor.

You may notice a dark brown discharge for a few weeks, but this will pass. You should not have sexual intercourse or use tampons for 4–6 weeks.

A cone biopsy may weaken the cervix. You can still become pregnant after a cone biopsy, but you may be at a higher risk of having a miscarriage or having the baby prematurely.

If you would like to become pregnant in the future, talk to your doctor before the procedure. 

Laser surgery

This procedure uses a laser beam (a strong, hot beam of light) to destroy or remove the abnormal cells. The laser beam is pointed at the cervix through the vagina.

Laser surgery is done under either local or general anaesthetic. It takes about 5–10 minutes, and you can go home after the treatment when you have recovered from the anaesthetic.

Laser surgery works just as well as LLETZ to remove precancerous cells and can be a better option if the precancerous cells extend from the cervix into the vagina or if the lesion on the cervix is very large.

Side effects of laser surgery are similar to those of LLETZ. You are usually able to return to your usual activities after 2–3 days, but you should not have sexual intercourse or use tampons for 4–6 weeks. You will also need to avoid baths, swimming pools and spas. 

“I had period-like pain for a few days after the cone biopsy but a hot water bottle and mild pain medicines helped a lot.” JULIE

Further tests

If any of the tests above show that you have cervical cancer, you may need further tests to find out whether the cancer has spread to other parts of your body. This is called staging.

Listen to the Tests and Cancer episode of  The Thing About Cancer podcast for further information.

Before having scans, tell the doctor if you have any allergies or have had a reaction to contrast during previous scans. You should also let them know if you have diabetes or kidney disease, or are pregnant or breastfeeding.

Blood test

You may have a blood test to check your general health, and how well your kidneys and liver are working. 

Imaging scans

You may have one or more of the following imaging scans to find out if the cancer has spread to lymph nodes in the pelvis or abdomen, or to other organs in the body:

CT scan

Uses x-rays to take pictures of the inside of your body and then compiles them into a detailed, three-dimensional picture. It is painless and takes 5–10 minutes.

MRI scan

Uses a powerful magnet and radio waves to create detailed cross-sectional pictures of the inside of your body. It is painless and takes between 30 and 90 minutes. Let your medical team know if you have a pacemaker or any other metal implant, as some may affect how an MRI works. 

PET–CT scan

A specialised imaging test that provides more detailed information about the cancer than a CT scan on its own. Not all people need to have a PET–CT scan.

You will be injected with a glucose (sugar) solution containing a small amount of radioactive material to help cancer cells show up brighter. Let your doctor know if you are claustrophobic, as you need to be in a confined space for the scan.

It may take a few hours to prepare, but the scan itself usually takes about 30 minutes.

Examination under anaesthetic

Another way to check whether the cancer has spread is for the doctor to examine your cervix, vagina, uterus, bladder and rectum. This is done in hospital under general anaesthetic.

If the doctor sees any abnormal areas of tissue during the procedure, they will usually take a biopsy. The area examined will depend on where the cancer may have spread to and may include:

  • Pelvic examination – the doctor will put a speculum into your vagina and spread the walls of the vagina apart so they can check the cervix and vagina for cancer.
  • Uterus – the cervix will be dilated (gently opened) and some of the cells in the lining of the uterus (endometrium) will be removed and sent to a laboratory for examination. This is called a dilation and curettage (D&C).
  • Bladder – a thin viewing instrument with a camera and light on the end (a cystoscope) will be inserted into your urethra (the tube that drains urine from the bladder). This lets the doctor examine your bladder.
  • Rectum – the doctor will use a gloved finger to feel for any abnormal growths inside your rectum. To examine your rectum more closely, the doctor may insert an instrument called a sigmoidoscope, which is a tube with an attached camera.

For people who will be having radiation therapy, the doctor may implant small markers into the cervix or vagina to show the size and position of the cancer.

The markers (called fiducials) are made of gold and are about the size of a grain of rice. They can be seen on x-ray and CT scans and are used to guide radiation therapy treatment.

You will most likely be able to go home from hospital on the same day after one of these examinations. You may have some light bleeding and cramping for a few days afterwards. Your doctor will talk to you about the side effects you may have. 


Staging cervical cancer

Tests and procedures help doctors determine how far the cancer has spread. This is called staging and it helps your health care team recommend the best treatment for you.

Cervical cancer is usually staged using the International Federation of Gynecology and Obstetrics (FIGO) staging system, which classifies cervical cancer into four stages.

Each stage is further divided into sub-stages such as A, B and C, which indicate increasing amounts of tumour.

  • Early or localised cancer (stage 1) – cancer is found only in the tissue of the cervix.
  • Locally advanced cancer (stage 2) – cancer has spread outside the cervix to the upper two-thirds of the vagina or other tissue next to the cervix.
  • Locally advanced cancer (stage 3) – cancer has spread to the lower third of the vagina and/or the tissue on the side of the pelvis (pelvic wall). The cancer may also have spread to lymph nodes in the pelvis.
  • Metastatic or advanced cancer (stage 4) – cancer has spread to the bladder or rectum (stage 4A) or beyond the pelvis to the lungs, liver or bones (stage 4B).


Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for anyone to predict the exact course of the disease.

Instead, your doctor can give you an idea about the general outlook for people with the same type and stage of cervical cancer.

To work out your prognosis, your doctor will consider:

  • your test results
  • the type of cervical cancer
  • the size of the cancer and how far it has grown into other tissue
  • whether the cancer has spread to the lymph nodes or other organs
  • other factors such as your age, fitness and overall health.

In general, the earlier cervical cancer is diagnosed and treated, the better the outcome. Most early-stage cervical cancers have a good prognosis with high survival rates.

Even if cancer is found after it has spread beyond the cervix (locally advanced cancer), it may still respond well to treatment and good outcomes are possible.

In recent years, clinical trials have led to new treatments that continue to improve the prognosis for people with metastatic cervical cancer.

Understanding Cervical Cancer

Download our Understanding Cervical Cancer booklet to learn more

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