Cervical Biopsy

By Nancy Bowers

(Biopsy-Cervix, Cervical Punch Biopsy, Cone Biopsy, Conization)

Procedure overview

What is a cervical biopsy?

A cervical biopsy is a procedure performed to remove tissue from the cervix to test for abnormal or precancerous conditions, or cervical cancer.

The cervix is the lower, narrow part of the uterus (womb) located between the bladder and the rectum. It forms a canal that opens into the vagina, which leads to the outside of the body.

Types of cervical biopsies

There are several types of cervical biopsies. In addition to removing tissue for testing, some of these procedures may be used to completely remove areas of abnormal tissue and may also be used for treatment of precancerous lesions.

Types of cervical biopsies include:

  • Punch biopsy—a surgical procedure to remove a small piece of tissue from the cervix. One or more punch biopsies may be performed on different areas of the cervix.

  • Cone biopsy or conization—a surgical procedure that uses a laser or scalpel to remove a large cone-shaped piece of tissue from the cervix

  • Endocervical curettage (ECC)—a surgical procedure in which a narrow instrument called a curette is used to scrape the lining of the endocervical canal, an area that cannot be seen from the outside of the cervix

Other related procedures that may be used to help diagnose and treat abnormal or cancerous cervical cells include loop electrosurgical excision procedure (LEEP), colposcopy, and Pap test. Please see these procedures for additional information.

What are female pelvic organs?

The organs and structures of the female pelvis are:

  • Endometrium—the lining of the uterus

  • Uterus—also called the womb, the uterus is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum. The uterus sheds it’s lining each month during menstruation, unless a fertilized egg (ovum) becomes implanted and pregnancy follows.

  • Ovaries—two female reproductive organs located in the pelvis in which egg cells (ova) develop and are stored and where the female sex hormones estrogen and progesterone are produced

  • Cervix—the lower, narrow part of the uterus located between the bladder and the rectum, forming a canal that opens into the vagina, which leads to the outside of the body

  • Vagina—the passageway through which fluid passes out of the body during menstrual periods. Also called the "birth canal," the vagina connects the cervix and the vulva (the external genitalia)

  • Vulva—the external portion of the female genital organs

Reasons for the procedure

A cervical biopsy may be performed when cervical abnormalities are found during a pelvic examination, or abnormal cells are found during a Pap test.  A positive test for human papillomavirus (HPV), a sexually transmitted infection, may also be a reason for cervical biopsy. Certain types of HPV can cause cervical cancer and other less common types of genital cancers. A cervical biopsy is often performed as part of a colposcopy procedure, also called a colposcopy-guided cervical biopsy. A colposcopy is a procedure that uses a colposcope, an instrument with a special lens to magnify the cervical tissues.

A cervical biopsy may be performed to detect cancer of the cervix or precancerous lesions of the cervix. Cells that appear to be abnormal, but are not cancerous at the present time, are identified as precancerous. The appearance of these abnormal cells may be the first evidence of cancer that may develop years later.

A cervical biopsy may also be used to diagnose and assist in the treatment of the following conditions:

  • Polyps (benign growths) on the cervix

  • Genital warts, which may indicate infection with human papilloma virus (HPV), a risk factor for developing cervical cancer

  • Diethylstilbestrol (DES) exposure in women whose mothers took DES during pregnancy, as DES exposure increases the risk for cancer of the reproductive system

There may be other reasons for your physician to recommend a cervical biopsy.

Risks of the procedure

As with any surgical procedure, complications may occur. Some possible complications may include, but are not limited to, the following: