ASCCP - Practice Recommendations - Practice Management Materials

PRACTICE RECOMMENDATIONS: Practice Management Materials

• Vulva • Vagina • Cervix • Anus

THE CERVIX: Colposcopy: Brief history of colposcopy

• I.	Introduction	• V.	Invasive Cancer of the Cervix
• II.	Anatomy of the Uterine Cervix	• VI.	Colposcopy
• III.	Histology of the Normal Cervix	• VII:	Cervical Cancer Screening and Colposcopy During Pregnancy
• IV.	Premalignant Lesions of the Cervix		Cervical Cancer Screening and Colposcopy During Pregnancy

Colposcopy was introduced by Hans Hinselmann in 1925 in Germany. He theorized that it might be possible to detect cervical cancer at an early stage by properly illuminating and magnifying the cervix. Although the technique was widely accepted in Europe, it did not gain popularity in the U.S. or the United Kingdom primarily because of a cumbersome terminology that was difficult to translate into English.

In 1928 Shiller introduced the concept of placing iodine on the cervix to identify non-glycogen-containing areas, for biopsy. This became popular in the U.S. and further delayed the acceptance of the colposcope.

In 1941 Papanicolauo and Traut published their report on the use of vaginal pool cytology for detecting cervical cancer. In 1949 Ayre developed the wooden cervical spatula, and it became possible to obtain abrasive cervical smears rather than exfoliative cytologic samples, which improved the detection of cervical neoplasia. The Pap smear, thus, became the accepted method of screening for cervical neoplasia. Cytology is an effective screening method, and colposcopy is the appropriate clinical diagnostic technique for evaluation of an abnormal pap smear.