Colposcopy Policies
and Procedures
Colposcopy helps screen patients for cervical cancer with a much higher accuracy rate than the standard Pap smear, which can give false positive results up to 80 percent of the time, according to a position paper by the American Academy of Family Physicians (AAFP). Doctors perform colposcopies based on recognized indications for their use, and they must undergo comprehensive training while hopefully participating in an ongoing review and education process.
Description
The Mayo Clinic describes a colposcopy as a medical procedure to check for diseases of the cervix and vagina. If a patient's Pap smear has indicated possible trouble, the doctor may recommend this more thorough procedure. The doctor uses a speculum to open the vagina and observes the cervix through a lighted magnifying device known as a colposcope. The doctor then applies a weak solution of acetic acid to the patient's genital tract, then views the tissue through a green filter to check for abnormal-looking cells, according to the AAFP. If he sees possible abnormalities, he may remove tiny samples for further testing.
Indications
Along with double-checking an abnormal Pap smear, the AAFP states that normal reasons for performing a colposcopy include abnormal-looking genital tissues or cervix, possible rape or child abuse, elevated cervical cancer risk, or checkup following cancer treatment.
Training and Education
The AAFP discusses its educational methods regarding colposcopy and other procedures in its position paper. In association with the American College of Obstetricians and Gynecologists, the academy has created and implemented a set of guidelines for helping hospital directors and residents conduct their training. The colposcopy course includes a wide range of materials from established family physicians. The academy also urges hospitals to use proctoring, or evaluation by a peer staff member, to ensure physician competence.
Availability
The AAFP believes that if the number of family doctors offering colposcopy increases, the rate of cervical cancer cases may drop as people gain readier access to preventive exams and early detection. Telecolposcopy now allows patients in remote areas to receive colposcopies by video. As described in a grant proposal to the National Cancer Institute, a doctor takes high-definition digital images of the cervix and then sends them to a colposcopist for review. This procedure currently sees use as a forensic tool in sexual assault cases in Williamson County, Texas, according to an article in the Austin American-Statesman.
Considerations
While the AAFP and the Mayo Clinic both state that a doctor may well order a colposcopy directly on the evidence of a Pap smear, Medical News Today quoted a series of studies from the British Medical Journal questioning the effectiveness of this policy. These studies, known collectively as the Trial of Management of Borderline and Other Low-grade Abnormal Smears, claimed to find no advantage in immediate colposcopy over normal surveillance over time, either medically or in terms of cost effectiveness.
Tags: cervical cancer, Colposcopy Policies, Colposcopy Policies Procedures, Mayo Clinic, Policies Procedures
