Colposcopy and cervical intraepithelial neoplasia

Cervical cancer is caused by certain types of Human Papillomavirus (HPV) and is preceded by a long pre-cancerous stage of Cervical Intra-epithelial Neoplasia (CIN). Cervical cancer can be prevented by successful introduction of an HPV immunization programme and screening using HPV testing, cytology and colposcopy. In the last decade and going forward, significant progress has been made in cervical screening methodologies, which are likely to further reduce the disease burden of cervical cancer and morbidity associated with CIN. We now have a better understanding of the natural history of HPV infection and progression of CIN. Three vaccines are currently available and immunization programmes are well established in developed and developing countries. Cytology screening is currently done using liquid based cytology with additional HPV testing for triage and test of cure. This will be replaced in the UK, in the near future, with primary HPV screening. New adjunctive technologies to Colposcopy are now available that improve the sensitivity of Colposcopy and have the potential to reduce the morbidity associated with CIN.