CA: A Cancer Journal for Clinicians, Vol 32, 85-91, Copyright
© 1982 by American Cancer Society
Can Colposcopy Replace Conization?
Duane E. Townsend M.D.1 and
Ralph M. Richart M.D.2
1 Associate Director of Gynecologic Oncology and Clinical Chief of Gynecology of Cedars-Sinai Medical Center, and Clinical Professor of Obstetrics and Gynecology of the Division of Gynecologic Oncology of the University of California and the University of Southern California Schools of Medicine, in Los Angeles, California.
2 Professor of Pathology and Derector of the Division of OB/GYN Pathology of Sloan Hospital for Women of the College of Physicians and Surgeons of Columbia University in New York, New York.
The reintroduction of colposcopy and the introduction of outpatient therapy have significantly altered the management of the woman with an abnormal Pap smear. Routine conization is no longer considered mandatory, particularly for the lower grades of CIN.
We estimate that over 10,000 gynecologists in North America have received instruction in colposcopy. Virtually every teaching hospital and medical center has colposcopy available. It is a valuable evaluative tool, particularly with the increasing risk of CIN in young women and the fact that more women are delaying childbearing until the third and fourth decades of life. The technique does, however, require a rigorous period of training, significant experience, and strict adherence to an established evaluation protocol. In the hands of the neophyte, the consequences of inappropriate evaluation of the woman with an abnormal Pap smear can be tragic.
