From the Guidelines
A colposcopy is a diagnostic procedure that involves the examination of the cervix, vagina, and vulva using a colposcope after applying a 3-5% acetic acid solution, and may include obtaining colposcopically directed biopsies of suspected lesions. This procedure is typically performed to investigate abnormal cervical cancer screening tests, such as an abnormal Pap smear result, to determine the presence of precancerous or cancerous cells 1. The colposcope is a special instrument that magnifies the area, allowing the healthcare provider to visualize abnormal cells that may not be visible to the naked eye. Some key points to note about the colposcopy procedure include:
- The application of a 3-5% acetic acid solution to the cervix to make abnormal cells more visible 1
- The use of a colposcope to examine the cervix, vagina, and vulva 1
- The possibility of taking a small tissue sample (biopsy) if suspicious areas are identified 1
- The importance of the procedure in detecting cervical cancer early, when it is most treatable. The procedure itself typically takes about 10-15 minutes, during which the patient lies on an exam table with her feet in stirrups, and may experience mild discomfort, cramping, or light bleeding afterward 1. However, patients can usually resume normal activities immediately.
From the Research
Definition and Purpose of Colposcopy
- Colposcopy is a diagnostic procedure used to evaluate the cervix, vagina, and vulva for abnormal cell growth, such as dysplasia or cancer 2, 3.
- The purpose of colposcopy is to detect and diagnose precancerous or cancerous lesions, particularly those caused by human papillomavirus (HPV) infection 3, 4.
Procedure and Techniques
- Colposcopy involves the use of a colposcope, a specialized microscope, to examine the cervix, vagina, and vulva for abnormal cell growth 2.
- The procedure may include a biopsy, where a sample of tissue is taken for further examination 2, 5.
- Colposcopy can be used to evaluate the transformation zone (TZ) of the cervix, which is the area where the cervix meets the vagina 5.
Indications and Risk Assessment
- Colposcopy is indicated for women with abnormal cervical cancer screening results, such as abnormal Pap test or HPV test results 3, 6.
- The procedure is also used to evaluate women with symptoms such as vaginal or vulvar lesions, or those with a history of diethylstilbestrol (DES) exposure 2.
- Risk assessment is an important part of colposcopy, as it helps to identify women who are at high risk of developing cervical cancer 3, 4.
Accuracy and Limitations
- The accuracy of colposcopy-directed biopsy in detecting early cervical neoplasia has been shown to be around 71.9% 5.
- The procedure has limitations, including a high false positive rate and the potential for underdiagnosis or overdiagnosis of abnormal cell growth 6, 5.
- A combination of colposcopic findings, cytology, HPV testing, and colposcopy-directed biopsy is necessary for the correct diagnosis of high-grade squamous intraepithelial lesions (HSIL) 5.