Colposcopists' practice patterns in Latin America: An international cross-sectional survey

Cervical cancer is a public health issue worldwide. Colposcopy is a key tool in the early diagnosis of preinvasive disease. Its practice is heterogeneous due to variations in its performance and the training of professionals. This study aimed to describe colposcopy practice patterns among Latin American gynecologists. A web survey was conducted among colposcopists. A 60-item questionnaire was designed and piloted with 40 physicians. The survey was conducted online voluntarily through a link that was sent to 2217 gynecologist members of the Latin American Federation of Lower Genital Tract Pathology and Colposcopy (FLPTGIC) between April 2024 and January 2025. The survey was answered by 787 colposcopists, with a response rate of 35.49%. The majority were from Mexico (17.92%); 60.61% were women between 30 and 50 years of age. Almost all practitioners (98.68%) performed cervical assessments after applying acetic acid, and 49.94% used Lugol's iodine routinely. More than 90% examined the vulva, and 68.74% examined the vagina during colposcopy. Fewer than half of the participants always reported the colposcopic diagnosis according to the Rio 2011 Colposcopy Nomenclature, and three-quarters reported whether the squamocolumnar junction was visible. More than one-third (37.48%) followed the American Society of Colposcopy and Cervical Pathology guidelines, and 3.2% used International Federation for Cancer Prevention and Colposcopy terminology. When diagnosing dysplasia, more than 90% performed resective methods (91.74%), and colposcopy is the main follow-up strategy. There is a high degree of heterogeneity in training, colposcopic practice patterns, and therapeutic decisions in cases of preinvasive disease among Latin American professionals, even though several scientific associations have established standards and guidelines.