The importance of complementary cytology and colposcopy in a detection program

Since 1956, we have used cytology and colposcopy routinely as complementary methods and the percentage of positive results has brought us much closer to the ideal 100 per cent. In order to achieve this, it is essential to put to good use the experience acquired by cytologists and colposcopists and to constantly update and improve the technique employed. The population must be made aware of the benefits of the simultaneous use of these detection methods through health education. The possibilities of diagnostic prediction of cytology are already well known. By means of colposcopy, we may classify the findings as follows: 1) normal, 2) with benign pathology, 3) suspicious, requiring additional frequent control, 4) highly suspicious of neoplasm, 5) malignant. Using the combined methodology, we were able to detect the flaws in use of both methods separately. Considering the carcinoma in situ and microcarcinoma, the results amounted to 16.6 per cent of cytologic false negatives and 12.9 per cent of colposcopic false negatives, whereas applying both methods simultaneously, we obtained only 2.7 per cent of false negatives. As we mentioned previously, this percentage of error may be attributable to technical faults, associated pathology and/or anatomic-histologic localization. We emphasize our reference to the simplicity of our method, making it possible to dispense with exaggerated human and material requirements and, at the same time, obtain highly successful results.