Colposcopy

HPV and the Cervical Screening Test

If you are aged 25-74, you should have your first Cervical Screening Test two years after your last Pap test. If your test shows no HPV infection you do not need to have another screening for five years.

If your test results show a type of HPV infection needing further investigation, or abnormal cells are found that need treatment, your doctor or GP will refer you for additional tests.

The primary tests for diagnosing cervical cancer are colposcopy and biopsy. A colposcopy and biopsy are also the main tests for diagnosing vulvar and vaginal cancers.

Colposcopy and biopsy

A colposcopy is a procedure used to look closely at the cervix, vagina and vulva to help locate changed or abnormal cells and see what they look like. You will lie on your back and the doctor will use a speculum to open the vagina so they can look at your cervix, vagina or vulva through a magnifying instrument called a colposcope that has a light and resembles a pair of binoculars on a stand. Your doctor may coat your cervix and vagina with a fluid in order to show up any abnormal areas.

A colposcopy generally takes 10 to 15 minutes. You may feel some minor discomfort during the colposcopy.

A biopsy involves your doctor removing some tissue from the surface of the cervix, vagina or vulva. This may be done during the colposcopy. The tissue sample is sent to a laboratory to be examined under a microscope by a pathologist.

The results of the colposcopy and biopsy are generally available in approximately a week.

After a colposcopy with a biopsy, you may experience cramping similar to menstrual pain. You may want to ask your doctor for medicine to relieve the pain. There may also be some light bleeding or vaginal discharge for a few hours. Your doctor may advise you not to use tampons or have sexual intercourse for 2 to 3 days after a biopsy to enable the cervix to heal and reduce the risk of infection.

Further tests for cervical cancer

Cone biopsy is used where abnormal glandular cells in the cervix or early-stage cancer is suspected.

A large loop excision of the transformation zone (LLETZ) is the most common procedure to remove cervical tissue for examination and treatment of pre-cancerous changes of the cervix. LLETZ is usually done under local anaesthetic.

Further test for vaginal and vulvar cancers

You may need additional test to assess your general health, determine the position and size of the tumour and see if the cancer has spread. These tests may include:

• chest x-ray to look at your lungs
• blood tests to see how your kidneys and liver are functioning
• cystoscopy where a doctor uses a thin, flexible tube with a light and camera (cystoscope) to look inside the urethra and bladder
• proctoscopy where a doctor uses a thin tube with light and camera (proctoscope) to look inside the rectum and anus
• imaging scans such as MRI scan and CT scan.

Sources:

• Understanding Cervical Cancer, Cancer Council Australia, © 2019. Last medical review of booklet: September 2019.
• Understanding Vulvar and Vaginal Cancers, Cancer Council Australia, © 2018. Last medical review of booklet: October 2018.fee
• Australian Institute of Health and Welfare (AIHW). Australian Cancer Incidence and Mortality (ACIM) Books. Canberra: AIHW.