Colposcopy is a process that involves using a magnifying lens (colposcope) to examine the cervix, vagina, and vulva to find aberrant epithelial patterns. The colposcopy technique begins with the removal of cervical mucus using normal saline. A Colposcope, which magnifies the tissue with filtered and unfiltered light, is used to examine the cervix. The cervix and upper vagina are subsequently treated with a 3-5% acetic acid solution. A biopsy is performed if an epithelial abnormality is found. If the entire lesion cannot be seen, an endocervical curettage is recommended. During pregnancy, colposcopy is performed to rule out the presence of invasive cancer and to reassure the lady that an abnormal Pap test will not impact her pregnancy.

HPV vaccination promises to lower cervical cancer risk in the coming decades, but it will also reduce the prevalence of CIN2+ lesions in the short term. As a result, the specificity of screening tests will be reduced, as will the sensitivity of colposcopy. Longer screening intervals, more HPV-based evaluation, more intermediate triage tests before Colposcope, and a shift towards prompt treatment without colposcopy for women at highest risk will be opportunities for future adjustments to screening and care techniques.

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