[Combined use of colposcopy and cytology]

The widespread view of the nearly absolute accuracy of cervical cytology in the diagnosis of severe dysplasia, carcinoma in situ and small invasive carcinoma is not correct. The rate of cytologically missed cases computed from the first smear only is more than 10%. Using cytology and colposcopy simultaneously in each single case, the errors of one method will be greatly compensated by the other. Presupposition for the compensation, however, is the independent indication for biopsy. In other words, biopsy must be done based on cytological findings, even when colposcopy is unsuspicious. On the other hand a colposcopically suspected and cytologically unsuspected case must also be biopsied. For the gynecological clinic as well as for the gynecological practice, the additional effort resulting from the combined method is easily realizable. For large screening programs, however, the colposcope can be used only as an instrument for target punch biopsies, indicated by pathologic smears.