{"id":3781,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/cervicalabnormalitiescolposcopy\/"},"modified":"2026-01-29T17:28:33","modified_gmt":"2026-01-29T17:28:33","slug":"cervicallesionscolposcopy","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/gynaecology\/cervicallesionscolposcopy\/","title":{"rendered":"Cervical lesions – Colposcopy"},"content":{"rendered":"\n

Cervical cancer affects all adult age groups, with above 50% of cases occurring between the ages of 30 and 50 years. 40% of new cervical cancer cases in women of screening age (25-64 years) were screen detected in Scotland in 2022.<\/p>\n\n\n\n

All patients with abnormal bleeding (IMB \/ PCB \/ PMB) or excessive discharge (+\/- pelvic pain) should have a speculum examination to rule out a cervical \/ vaginal \/ vulval malignancy.<\/p>\n\n\n\n

A smear is not required unless indicated by SCCRS guidance e.g. smear due or previously defaulted. Cervical sampling is intended to be used as a screening tool to detect pre-cancerous changes in asymptomatic people, not for diagnosing symptomatic cancers. Most cervical lesions are benign and may be referred routinely to general gynaecology<\/p>\n\n\n\n

\"colposcopy<\/figure>
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Normal cervix<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\"colposcopy<\/figure>
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Atrophic cervix \/ vagina<\/u><\/strong>         <\/p>\n\n\n\n

Cervix +\/- vagina may appear vascular \/ red after menopause due to atrophy<\/p>\n\n\n\n

\u2192 May benefit from topical estrogen if sympto<\/strong>matic<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\"colposcopy<\/figure>
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Cervical Cancer<\/u><\/strong>   <\/p>\n\n\n\n

Fungating +\/- ulcerated lesions, irregular, friable<\/p>\n\n\n\n

\u2192 Refer to colposcopy as USOC<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\"colposcopy<\/figure>
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Cervical polyps<\/u><\/strong>                           <\/p>\n\n\n\n

Usually benign \/ smooth outpouching of the lining of the cervix<\/p>\n\n\n\n

\u2192 Refer routinely to general gynaecology for removal<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\"colposcopy<\/figure>
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Cervical ectropion \/ ectopy<\/u><\/strong>    Physiological <\/p>\n\n\n\n

\u2192 Only requires treatment if causing bothersome symptoms (PCB or excessive discharge) and patient wishes intervention<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\"colposcopy<\/figure>
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Nabothian follicles<\/u><\/strong>                    Physiological (blocked glands) <\/p>\n\n\n\n

\u2192 No intervention required<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

\"colposcopy<\/figure>
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  Prior LETZ treatment (at colposcopy)<\/u><\/strong>    <\/p>\n\n\n\n

Scarring  \/ may appear like an ectropion \/ will persist after menopause <\/p>\n\n\n\n

\u2192 Manage like an ectropion<\/strong><\/p>\n<\/div><\/div>\n\n\n\n

All the images above are with permission from the NHS Cancer Screening Programmes.<\/em><\/p>\n\n\n\n

B.C. & L.P. 29-1-26<\/strong><\/p>\n\n\n\n