Colposcopy is a non-invasive optical method for the early detection of premalignant and malignant changes on the external genital organs of a woman. The very name of the method comes from the Greek words “colpos” and “scopia”, which literally means observing the vulva. Cervical cancer is among the most common causes of death in women, with a peak incidence between the ages of 35 and 49. It is clear how much this method has revolutionized the primary and secondary prevention of malignant tumors in this region.
How is this method performed?
Colposcopy is performed before the classical bimanuel examination. First, under the magnifying glass, the vulva is observed, then a speculum is placed in the vagina and a vagina and cervix are examined. The examination is non-invasive and it is as uncomfortable and painful as classic gynecological examination. During colposcopic examination, cells from the surface of the cervix are taken by special sticks to be sent for cytological analysis – the PAPA test.
Recently, a modified cytological division has been used, according to Bethesda, which also included the criterion of adequacy, that is, evaluation of the quality of the preparation itself and the possibility of indicating changes in relation to the Human papilloma virus.
According to the Bethesda classification, it is fundamental that changes in cells are divided into those:
• Low grade abnormalities – “SIL – Low grade squamous intraepithelial lesion”
• High grade abnormalities – “HSIL – High grade squamous intraepithelial lesion”
In addition to cytological examination of cells during colposcopy, knowledge of a series of colposcopic images allows us to distinguish microscopically visible benign from potentially malignant changes.
Colposcopic images can be divided into V groups:
• group I – normal colposcopic findings (normal squamous epithelium, normal transformation zone, ectopia)
• group II – abnormal colposcopic findings (AW epithelium, punctures, mosaic, leukoplakia, atypical blood vessels)
• Group III – colposcopically suspected invasive cancer
• group IV – unsatisfactory colposcopy findings (severe inflammation or tissue atrophy,)
• group V – other colposcopic images (condylomas, ulceration, inflammation, atrophy)
* It is recommended that women perform a colposcopy examination once a year during the reproductive period. Joint colposcopic examinations and PAPA tests can detect and prevent life-threatening illness in a timely manner.