Background: An “unhealthy cervix” or grossly abnormal cervix can harbor premalignant cervical lesions or invasive carcinoma even when the Papanicolau test report is negative for these pathologies. Methods: Colposcopic evaluation of the cervix was undertaken at a tertiary-care center in 356 women who were referred from 2000 to 2008 with “unhealthy cervix,” contact bleeding, and doubtful carcinoma of the cervix. Colposcopic directed biopsy was performed to investigate abnormal areas in these women, and the incidence of cervical intraepithelial neoplasia and invasive cervical carcinoma was determined. Results: The most common histopathologic diagnosis was chronic cervicitis. Human papilloma virus (HPV) lesions accounted for 20.5% of the cases and cervical intraepithelial neoplasia (CIN) 1 for 13% and CIN 2/3 for 11% of the cases. Invasive cervical cancer was diagnosed in 5.34% of the cases. Conclusions: It is essential to subject all cases of “unhealthy”/grossly abnormal cervix to colposcopic evaluation when the conventional Papanicolau test is negative for squamous intraepithelial lesion/carcinoma to rule out CIN or invasive cancer. (J GYNECOL SURG 27:5)
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