Cervicovaginal cytology is considered a very successful screening method for the detection of early cervical neoplasia. There have been many studies correlating cytology with colposcopy. By contrast, I have not heard much about cervicography. I am curious to know what this methodology entails and how it compares with cytology and colposcopy.)
An abnormal cervical smear is customarily managed in the clinical setting by referral for colposcopic examination. Colposcopy permits ready identification in the majority of cases of the area of atypia from which the abnormal smear has arisen. It is well demonstrated in the literature that simultaneous use of cytology and colposcopy increased the accuracy of detection of cervical neoplasia.
Screening colposcopy, however, has not been undertaken on a large scale because of the cost of colposcopes, the amount of time required, and insufficient experts in colposcopy. Colposcopy is reserved in most settings for the investigation of an abnormality detected on cervical screening. In some patient populations, e.g., gynecologic oncology clinics and sexually transmitted disease clinics, colposcopy may be employed as a screening tool. In the general clinical setting and relevant particularly to the more broad population based epidemiological studies of prevalence and natural history of SPI and CIN, colposcopy cannot be used for screening. Yet the false-negative rate of the Papanicolasu (Pap) smear prevents accurate allocation of patients as cases and controls. To provide the possibility of colposcopic screening and consultation, a new cervical screening technique called cervicography has been developed by Dr. Adolf Stafl.
This technique is now gaining wider acceptance within the clinical setting but is invaluable in research studies. The preparation of the cervix for cervicography is similar