Cervical Biopsy Overview

How the Procedure Works and How to Interpret the Lab Results

Cervical Pap smear showing abnormal cells
Cervical Pap smear showing abnormal cells. Spike Walker/The Image Bank/Getty Images

A cervical biopsy is a procedure that is sometimes done on women during an exam called a colposcopy to remove cervical tissue for examination. It is also called a punch biopsy. It is usually performed when a Pap smear result is either inconclusive or abnormal and a doctor wants to screen further for any cervical dysplasia or cervical cancer.  

How the Procedure Works

A cervical biopsy is normally performed during an in-office procedure called a colposcopy. A colposcopy is usually recommended after a regular Pap smear (or Pap test), another kind of cervical exam, reveals inconclusive or abnormal results. A colposcopy is a procedure that provides a gynecologist—a doctor who specializes in women's reproductive health—with a more in-depth look at the cervix. 

A colposcopy is very similar to a Pap smear. During this 10- to 15-minute exam, a woman lies on her back on the exam table, naked from the waist down, and places her feet in stirrups. The doctor inserts a medical tool called a speculum into the vagina and then puts a solution on the cervix to make any abnormal areas easier to see. Then the doctor will position a large, electric microscope with a bright light (a colposcope) about 30 centimeters from the vagina to get a better view of the cervix. Once the doctor identifies any abnormal areas of the cervix (these areas will usually appear to be white in color), he or she will take a cervical biopsy, which is a tissue sample, from the whitest area(s) and send it to a lab for analysis. 

Another type of biopsy called an endocervical curettage (ECC) may be performed. An ECC removes tissue from the endocervical canal, the narrow passageway that connects the cervix to the uterus.

Preparing for a Cervical Biopsy

It is recommended that women not have sex or douche 24 to 48 hours before a colposcopy or cervical biopsy. These activities increase the odds of an inaccurate test result. 

Does It Hurt?

Most women experience little to no discomfort during a cervical biopsy. Many doctors will ask a woman to cough just as the sample is being taken to alleviate any immediate discomfort. However, in the days following the procedure, you may experience some mild discomfort, so keep reading for those details. 

Understanding the Results

Results from a cervical biopsy typically come back within two weeks. Results will come back as either: normal or abnormal.

Abnormal results from a cervical biopsy can indicate low-grade dysplasia (mild) to high-grade dysplasia (moderate to severe). Cervical dysplasia is a common condition, and it means that there are precancerous changes to the cervix. Untreated cervical dysplasia may lead to cervical cancer in some cases, but having cervical dysplasia does not mean that you have cancer or that you will necessarily develop the disease. Many times, a doctor will take a "wait and see" approach to monitor the condition and see whether it persists because it can take many years for cervical cancer to develop. If the condition gets worse, certain outpatient procedures can be done to treat or remove the cells before they turn into cancer. Cervical dysplasia usually does not cause any symptoms, so that's why it's important to get regular screenings from your doctor.

Abnormal results from a cervical biopsy can also indicate cervical cancer. When cervical cancer is caught in its earliest stage, the survival rate is 93%.

What Happens After a Cervical Biopsy

You may experience normal bleeding up to a week after a cervical biopsy, as well as cramping. Most doctors recommend no sex or tampons for up to two weeks after a biopsy, depending on the circumstances. Report any heavy bleeding or discharge (whether it's foul-smelling or not), as well as any fever to your doctor.