Colposcopy (cont.)

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Biopsy of the cervix

Finally, colposcopy allows tissue sampling (biopsy) that is targeted to the abnormal areas. In fact, the biopsy of abnormal areas is a critical part of colposcopy because treatment will depend on how severe the abnormality is on the biopsy sample. After colposcopy and biopsies, a chemical is applied to the biopsy area to prevent bleeding (spotting). As part of the biopsy procedure, endocervical curettage (sampling of the tissues within the endocervical canal, or the opening of the cervix to the uterine cavity) is often performed.

Based on the colposcopy results, what is the approach to treating cervical abnormalities?

If the biopsy results show pre-cancer (dysplasia) or cancer, treatment is recommended. The dysplasia may be mild, moderate, or severe. Almost all women with dysplasia can have their treatment procedures performed in the doctor's office. The physician chooses between two general types of treatment. The first type is destruction (ablation) of the abnormal area, and the second type is removal (resection). Both types of treatment cure 90% of patients with dysplasia, meaning that 10% of women will have a recurrence of their abnormality after treatment. Generally, destruction (ablation) procedures are used for milder dysplasia and removal (resection) is recommended for more severe dysplasia or cancer.

The destruction (ablation) procedures are carbon dioxide laser photoablation and cryocautery. The removal (resection) procedures are loop electrosurgical excision procedure (LEEP), cold knife conization, and hysterectomy. Only certain, carefully chosen cases of cervical cancer are treated with LEEP or cold knife conization. Most cases of cervical cancer and occasional cases of severe dysplasia are treated by hysterectomy. Treatment for dysplasia or cancer is not usually done at the time of the initial colposcopy, since the treatment depends on the analysis of the biopsies done during colposcopy.

Medically Reviewed by a Doctor on 2/21/2014

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