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A cervical LEEP or conization should be done when: colposcopy cannot determine if there is an invasive cancer, when there are no obvious lesions on the cervix, and the Pap smear is consistently abnormal, when a colposcopically-directed biopsy does not adequately account for abnormal cells found on a Pap smear, when a diagnosis of microinvasion early invasion is found on the biopsy, when a squamous intraepithelial lesion is identified by a scraping from the cervical canal endocervical curettage , or when there is a diagnosis of adenocarcinoma in situ of the cervix.