Advances in colposcopy and management of cervical intraepithelial neoplasia

Cervical intraepithelial neoplasia remains a significant problem with regard to diagnosis and treatment. The emphasis has now shifted toward selection for treatment, partly as a result of an improved understanding of risk and partly as a result of simple excisional methods of treatment with low morbidity. It is now apparent that diagnoses based on small directed biopsy specimens may be misleading and whole transformation zone specimens should be regarded as the ideal. Although the role of oncogenic human papillomaviruses still remains obscure with regard to the etiology of cervical intraepithelial neoplasia, continued investigation is essential and rewarding in terms of an improved understanding of the molecular biology of malignant transformation and the interaction of transformed cells with the host's immune system.