THE COLPOSCOPIC SCREENING

The objective of this paper is a valuation of colposcopy as a screenin g tool. As database, 392 patients with histologically confirmed intrae pithelial neoplasia were used. Colposcopic and cytologic findings were compared with the final histologic diagnosis. The following results w ere obtained: (1)The colposcopic findings correlated with the histolog ic diagnosis to a significantly higher degree than the cytologic findi ngs. Depending upon the rate of dysplasia, the colposcopic findings pr edicted the diagnosis in 84-97%. (2) The false-negative rate of cytolo gy in condylomatous lesions and mild dysplasia was high (39 and 26%, r espectively), in particular in comparison with the false-negative rate of colposcopy of 5% for both lesions. Thus, a negative smear does not exclude consistently a dysplasia of the cervix. (3) The false-negativ e rate of cytology for the high grade lesions (GIN II and CIN III) was 13 and 1% respectively and, thus, lower than in the low grade lesions . There were, however, considerable discrepancies in comparison with t he histologic rating of the lesion. In CIN III cytology correlated wit h histology in only 61%, colposcopy, however, 85% (P < 0.001). Our res ults demonstrate that colposcopy is an excellent tool for detecting HP V caused lesions especially subclinical lesions and CIN I. Colposcopy is also a corrective for the false-negative cyto-smear rate (about 20- 40%). Thus, colposcopy may be used as an effective quality assurance m ethod and an excellent screening method in that colposcopy is superior in grading dysplastic lesions of the cervix. The application of the E uropean terminology was advantageous.