ASCCP Colposcopy Standards: Role of Colposcopy, Benefits, Potential Harms, and Terminology for Colposcopic Practice.

Michelle J Khan Claudia L Werner Teresa M Darragh Richard S Guido Cara Mathews Anna-Barbara Moscicki Martha M Mitchell Mark Schiffman Nicolas Wentzensen L Stewart Massad E J Mayeaux Alan G Waxman Christine Conageski Mark H Einstein Warner K Huh

J Low Genit Tract Dis

1Departments of Obstetrics and Gynecology, and Adult and Family Medicine, Kaiser Permanente Northern California, San Leandro, CA; 2Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX; 3Department of Pathology, University of California, San Francisco, CA; 4Magee Women's Hospital of the UPMC System, Pittsburgh, PA; 5Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, RI; 6Department of Pediatrics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA; 7Department of Gynecologic Oncology, Yale University, New Haven, CT; 8Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD; 9Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University of Medicine, St Louis, MO; 10Department of Family and Preventive Medicine, Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia, SC; 11Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM; 12Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO; 13Department of Obstetrics, Gynecology and Women's Health, Rutgers New Jersey Medical School, Newark, NJ; and 14Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL.

Published: October 2017

Objectives: The American Society for Colposcopy and Cervical Pathology Colposcopy Standards address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. Working Group 1 was tasked with defining the role of colposcopy, describing benefits and potential harms, and developing an official terminology.

Methods: A systematic literature review was performed. A national survey of American Society for Colposcopy and Cervical Pathology members provided input on current terminology use. The 2011 International Federation for Cervical Pathology and Colposcopy terminology was used as a template and modified to fit colposcopic practice in the United States. For areas without data, expert consensus guided the recommendation. Draft recommendations were posted online for public comment and presented at an open session of the 2017 International Federation for Cervical Pathology and Colposcopy World Congress for further comment. All comments were considered for the final version.

Results: Colposcopy is used in the evaluation of abnormal or inconclusive cervical cancer screening tests. Colposcopy aids the identification of cervical precancers that can be treated, and it allows for conservative management of abnormalities unlikely to progress. The potential harms of colposcopy include pain, psychological distress, and adverse effects of the procedure. A comprehensive colposcopy examination should include documentation of cervix visibility, squamocolumnar junction visibility, presence of acetowhitening, presence of a lesion(s), lesion(s) visibility, size and location of lesions, vascular changes, other features of lesion(s), and colposcopic impression. Minimum criteria for reporting include squamocolumnar junction visibility, presence of acetowhitening, presence of a lesion(s), and colposcopic impression.

Conclusions: A recommended terminology for use in US colposcopic practice was developed, with comprehensive and minimal criteria for reporting.

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http://dx.doi.org/10.1097/LGT.0000000000000338	DOI Listing

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