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ASCCP Colposcopy Standards: How Do We Perform Colposcopy? Implications for Establishing Standards
Alan G Waxman1, Christine Conageski, Michelle I Silver
11Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM; 2Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, Aurora, CO; 3Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, 4Private Practice, Great Neck, NY; 5Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston Medical Center, Boston, MA; 6Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI; 7Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL; 8Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO; 9Departments of Obstetrics and Gynecology and Adult and Family Medicine, Kaiser Permanente Northern California, San Leandro, CA. 10University of South Carolina Department of Family and Preventive Medicine, Department of Obstetrics and Gynecology University of South Carolina School of Medicine, Columbia, SC11Department of Obstetrics, Gynecology, & Women's Health, Rutgers New Jersey Medical School, Newark, NJ; and 12Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical School Pittsburgh, PA.
Objectives:
The American Society for Colposcopy and Cervical Pathology (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.
Materials And 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 colposcopy practice guidelines were developed. These guidelines represent recommended practice in all parts of the examination including the following: precolposcopy evaluation, performing the procedure, documentation of findings, biopsy practice, and postprocedure follow-up.
Conclusions:
These guidelines are intended to serve as a guide to standardize colposcopy across the United States.
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