A Rapid Method for Improving Colposcopic Accuracy

Abstract

ABSTRACT

Four colposcopic signs (margins, color, vascular atypia, and iodine staining) are graded into three objective categories representing (1) subclinical papillomaviral infection, (2) lower-grade dysplasia, and (3) grade 3 cervical intraepithelial neoplasia. Attempts to grade lesions by the prominence of the acetowhitening reaction or the mere presence of aberrant surface capillaries are unsuccessful. In contrast, each of four colposcopic criteria described in this article is significantly correlated with histologic severity. Combined into a weighted index, these colposcopic features were 96% correct in forecasting approximate histologic findings. Because this method relies on critical analysis rather than pattern recall, the use of this colposcopic index greatly simplifies the learning of colposcopy.