Colposcopy: visual examination that remains the gold standard

In a colposcopy, the cervix is visually examined using a colposcope, which provides a magnified view of the cervix and surrounding tissues. In some cases, the cervix may be coated with acetic acid (vinegar), which temporarily turns abnormal cervical tissue white, and facilitates identification of abnormal tissue.1

cervical_colposcopyTrained clinicians use colposcopy to identify pre-cancerous or cancerous lesions. Based on degree of dysplasia observed, and in coordination with cytology findings from Pap screening, colposcopy may be accompanied by obtaining a biopsy sample or, when warranted, immediate excision or ablation of pre-cancerous tissue.2

For suspect or ambiguous cytology results, with or without hrHPV testing, colposcopy is often performed to determine which patients can return to routine screening and those who require more vigilant follow-up.

Despite the development of more advanced techniques, the visual assessment that colposcopy affords remains a mainstay of cervical cancer screening. Clinicians who are experienced with the technique feel more comfortable about their patient-care decisions when they are able to physically look at cervical tissue for the presence of, or potential for, dysplasia.

However, colposcopy can be unpleasant and some women may regard the procedure as invasive. There is acknowledged concern among women’s health stakeholders that the procedure is being unnecessarily prescribed for too many women.3

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