Cervical Precancer -
Diagnosis and Treatment - Colposcopy

A colposcopy examination involves the visualization of the cervix using a magnifying instrument (colposcope). Colposcopy is usually carried out by a gynaecologist or nurse with special training in the diagnosis and treatment of cervical precancer. The patient to be examined is positioned on an examination chair and a speculum is gently inserted to visualize the cervix. The colposcope is positioned to enable the examiner to view the cervix under magnification and with good illumination.

A fluid (acetic acid) is the applied to the cervix and the abnormal cells take on a white appearance (aceto-white), which is visible on colposcopy. This area may then be closely examined and further information obtained by a biopsy (small sample of tissue taken with a biopsy forceps), which can then be examined by the pathologist to confirm the presence of pre-cancerous disease. Alternatively colposcopy may be the preliminary to treatment whereby the abnormal area of cervical tissue is removed, usually by loop diathermy.

The procedure is usually carried out under local anaesthesia, which is injected directly into the cervix. The abnormal area is removed by cutting the tissue with an electrically heated wire loop (loop diathermy). This allows rapid and precise removal of the abnormal tissue. If the abnormal area is large then laser treatment may be recommended. This is usually performed under general anaesthesia. Occasionally a combination of laser and loop diathermy is used. Patients may also elect to have their treatment under general anaesthesia.

After the treatment the patient is informed as to the after effects in terms of bleeding and discharge and also what complications may occur. A follow up examination may be recommended at six months. In any event the first follow up smear is taken at six months and after that on the anniversary of treatment until five years have elapsed. The patient then returns to the normal screening program.