Screening for cervical cancer is currently by pap smear on a 2 yearly basis. In 2016 there will be a gradual change to the screening guidelines. In essence women will only need screening 3-5 yearly and will be screened by a HPV test sample taken from the cervix. Yes, a speculum will still be needed.
If pap smears (and later HPV tests) are reported as abnormal by the laboratory then the next stage of investigation is often a colposcopy. This involves looking at the surface of the cervix in more depth with a powerful focused light and a microscope. The cervix is then swabbed with a dilute ascetic acid (like white vinegar) and iodine. These two liquids stain the cervix and help to highlight areas likely to be affected by the HPV virus. We now know that abnormal pap smears, CIN, and cancer of the cervix are caused by HPV (the wart virus that affects the genital region).
A diagnosis at the time of colposcopy is subjective and if there are any affected areas these should be biopsied and sent to a laboratory for a definitive diagnosis and reporting. This report directs the level of surveillance or treatment that is required for each individual. Biopsy is performed under local anaesthetic and typically has little or no down time. Results are usually available 7 days later and require a follow up visit to the doctor for results and a management plan.