What Is a Cervical Biopsy?

A cervical biopsy is a medical test that looks for cervical cancer or changes in the cervix that could lead to cancer. The cervix is the bottom part of the uterus that connects to the top of the vagina. Your healthcare provider will recommend a cervical biopsy when a routine Pap smear shows an abnormal result. Generally, a gynecologist (a doctor specializing in women's health and the female reproductive system) performs these tests.

Purpose

The main purpose of a cervical biopsy is to test for cervical cancer—a slow-growing cancer that starts with abnormal changes in the cells of the cervix. Not all abnormal cells lead to cancer, but sometimes these cells head into a precancerous state called dysplasia. Over many years, cells that show dysplasia can develop into cervical cancer. Almost all cervical cancers are caused by the human papillomavirus (HPV) infection.

Before your provider thinks it's necessary to perform a cervical biopsy, they will first perform a Pap smear and test for HPV—both of which are standard tests during a routine pelvic exam. These are also the first steps in screening for cervical cancer. If you have normal results from your pelvic exam, your gynecologist will not recommend a cervical biopsy. But you may need a cervical biopsy for the following reasons:

• The presence of abnormal cells during a Pap smear
• Testing positive for HPV
• A growth or lump on your cervix
• Genital warts
• Irritation or inflammation of the cervix
• Experiencing bleeding after sex
• Abnormal or excessive vaginal bleeding
• Ongoing abnormal vaginal discharge

How Does It Work?

If you're getting a cervical biopsy, you will need to go to your healthcare provider's office to complete the exam. At your appointment, you will lie down on an exam table and your provider will use a special microscope called a colposcope to look at the cervix and the surrounding areas up close under a bright light. The test should take about 10 minutes and cause minimal discomfort.

Before the Test

There is no special preparation for a cervical biopsy. However, you may want to schedule your biopsy for when you are not on your period. The blood can sometimes make it difficult for your healthcare provider to see the cervix and the surrounding areas. But, if you're experiencing long or abnormal menstrual cycles, it's best to check with your provider to determine when it's a good time to come for your appointment.

Talk to your healthcare provider if you are or may be pregnant. While the test can be done safely during pregnancy, your healthcare provider may not want to disturb the cervix if you are expecting.

During the Test

Once you're at your appointment, your provider will ask you to lie on the exam table with your feet in stirrups, just as you would for a routine pelvic exam. Then, your provider will insert an instrument called a speculum into the vagina to gently hold it open so the cervix and the surrounding areas are visible. You will not need local anesthesia for this test, but it is possible to feel some cramping, pressure, or discomfort.

After your provider can properly see your cervix, they will clean the cervix with acetic acid solution (which is just like vinegar). This process makes it easier for your provider to see your cervix during the test. It's also possible to notice a slightly cold or burning feeling when they apply the acetic acid solution, but it should not hurt. If you feel excessive pain during the procedure, it's important to tell your provider.

Next, your provider will place the coloscope at the opening of the vagina. The colposcope has magnifying lenses that help your healthcare provider examine the cervix in detail.

If your provider finds any abnormal or concerning areas in your cervix, they might also take pictures of those areas. After viewing the cervix with the colposcope, your provider will perform a biopsy by removing a small sample of tissue from your cervix with a needle. Keep in mind: most people feel a slight pinch or cramp during the biopsy. Once your provider gets the sample of your tissue, they will control any bleeding and test will be complete.

After the Test

After your appointment, your provider will send the sample of your cervical cells to a lab for a pathologist (or, a specialist who can identify precancer or cancer cells) to examine the sample. It can take up to a couple of weeks to get your test results back.

Because a cervical biopsy is an outpatient procedure, you should be able to return to work or school right after the test. Some people experience nausea, lightheadedness, or dizziness after the test is complete. If you do have these symptoms, let your healthcare provider know. They may instruct you to lie down on the exam table until you feel ready to sit up.

You may have some light vaginal bleeding or spotting for a few days after the test. You may also notice a dark vaginal discharge for up to three days after the exam. It's also common to experience vaginal cramping or soreness for a couple of days. If these symptoms aren't going away after a few days, it's important to let your healthcare provider know—as this may be a sign of an infection.

It's worth noting that you should avoid putting anything in your vagina for 48 hours after the cervical biopsy. If you're on your period, it's best to use a sanitary pad rather than a tampon or menstrual cup. You should also avoid sex and masturbation until soreness and discharge go away.

Risks and Precautions

Generally, there are very few risks associated with a cervical biopsy. Once you're done with the test, it's also normal to feel some discomfort, cramping, and light bleeding for a few days after the test.

In rare cases, you might experience complications that could be signs of an infection. Contact your healthcare provider immediately if you have any of these symptoms:

• Heavy vaginal bleeding
• Abdominal pain or intense cramps
• Foul-smelling vaginal discharge
• Fever
• Chills

While a cervical biopsy is considered safe during pregnancy, it is only recommended if your provider suspects you have cervical cancer. If you are pregnant or trying to become pregnant, be sure to tell your provider this information so they can weigh the risks of the procedure.

How to Prepare for a Cervical Biopsy

Before you go in for your test, it's important to prepare for the exam. Proper preparation can help your test go smoothly when you're at your provider's office. Experts recommend the following preparation strategies:

• Do not insert anything into the vagina or have sex for 24 hours before the cervical biopsy. This includes using douches, creams, and tampons.
• Notify your healthcare provider if you are taking medications to prevent blood clots, such as aspirin, clopidogrel, heparin, or warfarin. These medications can increase your chance of bleeding during the test.
• Ask your healthcare provider if it is safe to take Advil (ibuprofen) or Tylenol (acetaminophen) before the test to reduce discomfort.
• Empty your bladder and bowel before going in for the biopsy to make the test more comfortable for you.
• It's common to experience some anxiety when getting tested for cancer. To ease any worries or concerns, ask a loved one to come with you to your appointment.

Results

After examining the tissue samples from your cervical biopsy, a pathologist will send a report of the results to your healthcare provider. The results are usually available in 7 to 14 days. Your healthcare provider will contact you to discuss the results via a phone, virtual, or in-person appointment.

Interpreting Your Results

A normal test result means the cervix has a normal appearance and you do not have any signs of precancerous or cancerous cells.

However, you might receive an abnormal test result if you have:

• Precancerous cells in the cervix
• Cervical warts from an HPV infection
• Cancerous cells in the cervix

If you have precancerous cells, your healthcare provider may discuss additional testing or treatment to prevent the cells from developing into cancer. If you have cancerous cells, your provider will likely refer you to an oncologist, or a cancer specialist, for treatment and next steps.

A Quick Review

Cervical cancer is currently the fourth most common cancer in women in the world. A cervical biopsy is a diagnostic test for cervical cancer that uses a special microscope to look at the cervix. Your provider may recommend this biopsy if you have an abnormal result from a pelvic exam. During the biopsy, they will take a close look at your cervix and take a sample of your cells to send in for testing. The results can help your healthcare provider decide how to manage precancerous cells or treat cervical cancer.