ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards

Abstract

Objectives The ASCCP Colposcopy Standards recommendations address the role of and approach to colposcopy and biopsy for cervical cancer prevention in the United States. The recommendations were developed by an expert working group appointed by ASCCP’s Board of Directors. Working Group 3 defined colposcopy procedure guidelines for minimum and comprehensive colposcopy practice and evaluated the use of colposcopy adjuncts. Methods The working group performed a systematic literature review to identify best practices in colposcopy methodology and to evaluate the use of available colposcopy adjuncts. The literature provided little evidence to support specific elements of the procedure. The working group, therefore, implemented a national survey of current and recent ASCCP members to evaluate common elements of the colposcopy examination. The findings of this survey were modified by expert consensus from the ASCCP Colposcopy Standards Committee members to create guidelines for performing colposcopy. The draft recommendations were posted online for public comment and presented at an open session of the International Federation for Cervical Pathology and Colposcopy 2017 World Congress for further comment. All comments were considered in the development of final recommendations. Results Minimum and comprehensive colpocoscopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the exam including: pre-colposcopy evaluation, performing the procedure, documentation of findings, biopsy practice and post-procedure follow-up. Conclusions These guidelines are intended to serve as a guide to standardize colposcopy across the U.S.

Observed Colposcopy Practice in US Community-Based Clinics: The Retrospective Control Arm of the IMPROVE-COLPO Study

“…Based on this large colposcopy data set of 3,602 patients collected from 44 US community-based clinics and 154 providers, we are able analyze and discuss cervical cancer prevention practices in the “real world.” In this setting, providers perform an average of only 2.3 colposcopies per month. For comparison, in a recent survey of the ASCCP that was used to support the development of practice guidelines, 13 32% of respondents performed 5 or less colposcopies per month and were considered “low volume.” The colposcopists included in our study are therefore also “low volume” and might be considered limited in their expertise.…”

Development and validation of an artificial intelligence system for grading colposcopic impressions and guiding biopsies

“…One of the primary goals in the application of CAIADS was to grade colposcopic impressions in accordance with the latest ASCCP colposcopy terminology: normal/benign, low-grade, high-grade, and cancer [ 16 , 17 ]. The CAIADS was also expected to dichotomously grade colposcopic impressions into two hypothetical biopsy thresholds (low-grade or worse versus normal/benign, and high-grade or worse versus a less severe impression).…”

Short-term clinical and immunologic effects of poly-gamma-glutamic acid (γ-PGA) in women with cervical intraepithelial neoplasia 1 (CIN 1): A multicenter, randomized, double blind, phase II trial

“…Twelve weeks after study entry, all subjects underwent colposcopic biopsy, HPV testing, and immune activity testing. At the colposcopy visit, biopsies were taken from suspected areas according to the protocol of this study based on American Society for Colposcopy and Cervical Pathology recommendations by expert gynecologic oncologist [19, 20]. If no abnormalities were seen, the examiner was directed to take two random biopsies.…”