Abstract
The purpose of this guideline is to help ensure the provision of high-quality colposcopy practices in the province of Ontario, including those conducted as diagnostic procedures in follow-up to an abnormal cervical screening test. This document updates the recommendations published in the 2008 colposcopy guideline from Cancer Care Ontario, The Optimum Organization for the Delivery of Colposcopy Service in Ontario. A systematic review of guidelines was conducted to evaluate the existing evidence and recommendations concerning these key aspects of colposcopy: □ Training, qualification, accreditation, and maintenance of competence□ Practice setting requirements□ Operational practice□ Quality indicators and outcomes. This guideline provides recommendations on training and maintenance of competence for colposcopists in the practice settings in which colposcopic evaluation and treatments are conducted. It also provides recommendations on operational issues and quality indicators for colposcopy. This updated guideline is intended to support quality improvement for colposcopy for all indications, including the follow-up of an abnormal cervical screening test and work-up for lower genital tract lesions that are not clearly malignant. The recommendations contained in this document are intended for clinicians and institutions performing colposcopy in Ontario, and for policymakers and program planners involved in the delivery of colposcopy services.
Highlights
Because of global inequities in the availability and quality of cancer screening, cervical cancer is the third most common cancer, with 528,000 new cases estimated worldwide in 20121
The recommendations contained in this document are intended for clinicians and institutions performing colposcopy in Ontario, and for policymakers and program planners involved in the delivery of colposcopy services
In Ontario, 610 new cases of cervical cancer were diagnosed in 2013, and 150 women were expected to die of their disease2
Summary
Because of global inequities in the availability and quality of cancer screening, cervical cancer is the third most common cancer, with 528,000 new cases estimated worldwide in 20121. Cervical cancer is the fourth leading cause of death for women worldwide, having resulted in an estimated 266,000 deaths the same year. In Ontario, 610 new cases of cervical cancer were diagnosed in 2013, and 150 women were expected to die of their disease. Colposcopy uses binocular magnification (5×–30× magnification) with a colposcope to examine the lower genital tract. It provides a visual diagnosis and allows the colposcopist to biopsy suspicious precancerous or cancerous lesions. Colposcopy plays an important diagnostic role in cervical cancer prevention in women with an abnormal screening test. Optimizing the quality of colposcopy services in Ontario—including their appropriateness, efficiency, and effectiveness—is important
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