Colposcopic Features of Cervical Intraepithelial Lesions

Abstract

Cervical cancer screening of women of appropriate age followed by treatment of the screen-detected abnormalities can significantly reduce the incidence of cervical cancer and also the mortality from the disease. Colposcopy is an important triage tool interposed between screening and histopathological diagnosis and treatment; therefore, a thorough knowledge of the procedure is essential for the providers. The characteristics of cervical intraepithelial neoplasia (CIN) on colposcopy depend on the grade of the lesion, and its diagnosis can be mastered by the providers with the help of the subject knowledge, clinical practice and self-evaluation by colposcopic-histopathological correlation. The key features that are evaluated during colposcopy are acetowhiteness, blood vessels, iodine staining, margin/surface of the lesion and lesion size. The International Federation of Cervical Pathology and Colposcopy (IFCPC) introduced a new system of nomenclature for colposcopy in the year 2011, in which the abnormal findings have been categorized as grade 1 or minor findings, grade 2 or major findings, suspected invasion and non-specific findings. The benign abnormalities have been grouped as miscellaneous findings. Describing the type of transformation zone and the final scoring of the abnormalities using the ‘Swede score’ has been made mandatory in the new nomenclature system.