Cervical cancer (CC) is the third most common cancer in the world, and
Romania has the highest incidence of cervical cancer in Europe. The aim of this study was to
evaluate the correlation between cytology, colposcopy, and pathology for the early detection of
premalignant cervical lesions in a group of Romanian patients. Methods: This observational type 2
cohort study included 128 women from our unit, “Bucur” Maternity, who were referred for cervical
cancer screening. Age, clinical diagnosis, cytology results, colposcopy impression, and biopsy results
were considered. Colposcopy was performed by two experienced examiners. The pathological
examination was performed by an experienced pathologist. Results: The cytology found high-grade
squamous intraepithelial lesions in 60.9% of patients, low-grade squamous intraepithelial lesions
in 28.1%, atypical squamous cells for which a high-grade lesion could not be excluded in 9.4%,
and atypical squamous cells of undetermined significance, known as repeated LSIL, in 1.6%. The
first evaluator identified low-grade lesions in 56.3%, high-grade lesions in 40.6%, and invasion in
3.1% of patients. The second evaluator identified low-grade lesions in 59.4%, high-grade lesions in
32.0%, and invasion in 8.6% of patients. The pathological exam identified low-grade lesions in 64.1%,
high-grade lesions in 25%, and carcinoma in 14% of patients. The colposcopic accuracy was greater
than the cytologic accuracy. Conclusions: Colposcopy remains an essential tool for the identification
of cervical premalignant cancer cells. Standardization of the protocol provided an insignificant
interobserver variability and can serve as support for further postgraduate teaching