Colposcopic Assessment Among Women with Lower Genital Tract Pathology

A broad spectrum of conditions classically requires a colposcopic assessment for either diagnostic or treatment means, including atypical changes in the cervix-vagina and vulva, abnormal Pap tests, cervicitis, polyps, cervical warts, genital warts, and bleeding. Although the procedure is commonly considered as criteria for the management of cervical cancer, the sensitivity of colposcopy is quite limited as its ability to discriminate among dysplasia and microinvasive carcinoma is difficult. Most professional societies and international health organizations have already released guidelines and recommendation for the management for woman with abnormal cervical pathology (e.g., cervical intraepithelial neoplasia and cervical cancer); only women with positive human papillomavirus (HPV) tests, low-grade squamous intraepithelial lesion (LSIL), or severe cytology have clear indication for referral to a colposcopic evaluation. While most guidelines recommend colposcopy for any abnormal cytology or any positive HPV test, others apply only for woman with two consecutive unsatisfactory Pap tests or for those with some abnormalities. In conclusion, cervical cancer risk remains high; thus, the potential benefit of colposcopy examination should be balanced against the risk

Psychosocial Aspects of Colposcopic Assessment: Perspectives and Strategies for Physicians

The purpose of this work is to determine perspectives, misconceptions, psychology adjustments and useful strategies of women living with dilemmas about their malignant lesions which can be detected through the colposcopy. Colposcopic assessment following abnormal Pap test has resulted in a long list of concerns: fear of having cancer, periodic obligations related to follow-up, balancing treatment of premalignant disease with quality of life, pain or discomfort and long-term impact on their families or limited social support. How prepared are they to adapt to their diagnosis? New diagnosis results in patient not being able to listen well or to understand her medical situation. The success of the outcome and procedure takes time to deduce the concerns she has regarding her diagnosis, treatment and appropriate follow-up. Several physicians endorse a wide range of barriers with respect to diagnosis and management of the disease: organizational or patient issues. Furthermore, patient appears to be important for the effective treatment than to identify and assess psychosocial problems among women diagnosed with cancer. In conclusion, physician provides effective treatment, but fails to address psychosocial issues associated with the illness. It is necessary to define the condition more clearly by studying patients and their psychosocial problems