Cervical Pathology is the science of the causes and effects of
diseases related to cervix with laboratory examination for diagnostic purposes. Major diseases of Cervix include: Cervical endometriosis, Ectropion and endocervicitis etc. Cervical cancer prevention depends upon detection and treatment of high-grade (CIN2,3) cervical lesions most likely to progress to invasive cancer in the absence of treatment. Two primary cervical screening tests are now in use The Pap test, which includes the conventional Pap smear and the liquid-based Pap test.
A colposcopy is a close-up view of the cervix, vagina and vulva
for signs of disease. It is used to detect abnormal cells on the cervix. During a colposcopy procedure, physician uses a colposcope an instrument that looks like binoculars with a bright light mounted on a stand. Colposcopy is usually done in one of two circumstances: to examine the cervix either when the result of a Pap smear is abnormal, or when the cervix looks abnormal during the collection of a Pap smear.
Worldwide, it is estimated that there are 528,000 new cases of
cervical cancer each year and that 266,000 women die from the disease. In the United States, the National Cancer Institute (NCI) estimates that 1,200 new cases of cervical cancer will be diagnosed in 2015, and that 4,100 women will die from the disease. Currently, the five-year survival rate for localized cervical cancer is 91.5%; the overall (i.e., all stages combined) five-year survival rate is approximately 67.8%. Cervical cancer was once one of the most common causes of cancer death among U.S. women, but since the 1980s, the cervical cancer death rate in the United States has decreased by more than 50%.
Studies show that access to health care is an important
predictor of cancer screening. In the United States, pap tests are ordered or provided in approximately 29.4 million physician office visits each year, and it is estimated that more than 3 million women get unclear or abnormal results.
Colposcopy is the diagnostic test indicated for evaluating
patients with abnormal Pap test results. 7During the procedure, features of the cervical epithelium are examined under magnified illumination after the application of normal saline, 3% to 5% dilute acetic acid, and Lugol iodine solution in successive steps. A green filter highlights vascular patterns.
colposcopy is usually done in one of two circumstances: to
examine the cervix either when the result of a Pap smear is abnormal, or when the cervix looks abnormal during the collection of a Pap smear. Even if a Pap smear result is normal, colposcopy is sometimes necessary when the cervix appears visibly abnormal to the clinician performing the Pap smear. The purpose of the colposcopy is to determine what is causing the abnormal looking cervix or the abnormal Pap smear so that appropriate treatment can be given.
Neither cytologic sampling nor colposcopic examination alone
provides definitive answers. If abnormal tissue is present, it is the histologic result that provides the basis for treatment or observation.
Colposcopy the traditional next step after an abnormal smear
test relies on the presence of visible indicators to detect atypical cells on the cervix. Unfortunately, these indicators are not specific to cervical intra-epithelial neoplasia (CIN), especially low-grade CIN, which means that interpretation is subjective. Thats why we take biopsies to confirm the presence of disease before offering treatment. But biopsies are invasive and as it can be difficult to judge the best location, we sometimes need to take more than one tissue sample, which can add to patient discomfort. Even after the biopsy is complete, it can take up to two weeks to receive the histology results, making waiting patients understandably anxious. In the majority of cases, the abnormal tissue will regress naturally, so to avoid unnecessary and potentially harmful treatment, we tend to recall these patients for repeat colposcopy at six- to 12-month intervals only increasing the time and effort, in addition to uncertainty for the patient.