Colposcopy :
what is going to change?
Dr Christine Bergeron
Laboratoire Cerba
Cergy Pontoise
France

The outcome will remain the histologic diagnosis
• The biopsy should be obtained under colposcopy
• The biopsy should be taken around the squamous-columnar
junction
• The performance of the histologic diagnosis will depend of the
expertise of both the colposcopist and the pathologist

HPV Test
- +
Colposcopy
1 y
Pap smear3 ys
4 ys
+ -
p16/ki67
option if < 30 ys
Pap smear
+ -
Colposcopy
2 ys
Pap smear
ASC-US

Colposcopy
1 y
+
Pap smear or HPV test
-
p16/Ki67
Cytologic LSIL

Supplements to EU guidelines for quality assurance in cervical cancer
screening
Eds: A.Anttila, M.Arbyn, H.De Vuyst, J.Dillner, L.Dillner, S.Franceschi,
J.Patnick, G.Ronco, N.Segnan, E.Suonio, S.Tornberg, L.von Karsa
Guidelines can be downloaded at:
http://bookshop.europa.eu/en/european-guidelines-for-quality-assurance
-in-cervical-cancer-screening-pbEW0115451/?AllPersonalAuthorNames=true

Test HR HPV
Negative
Test HPV 5 ys
Positive
Cyto and/or HR HPV 1 yr
Normal/ Neg
Abnormal
Colposcopy
Abnormal/ Pos
Cytology
Normal
Primary screening HPV cytological triage :
Organized screening programme
European guidelines for quality assurance in cervical cancer screening 2015
Colposcopy

Test HR HPV
Negative Positive
Cytology p16 / Ki 6716/18
Positive
Primary screening HPV with triage strategies
Combinations of different tests ? Interval between tests if negative?
Test HPV 5 ys
NegativeNormal or
ASC-us or LSIL
PositiveNegative
Test HPV 3ys Test HPV3ys Test HPV 3ys
HSIL
Colposcopy Colposcopy Colposcopy

Colposcopy in the context of primary
cytology or HPV screening
• The diagnosis will be in the hand of the colposcopist
• Will need education and training of the colposcopists
• Will need evaluation