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Eur J Obstet Gynecol Reprod Biol. 2018 May;224:137-141. doi: 10.1016/j.ejogrb.2018.03.024. Epub 2018 Mar 16.

2017 update of the European Federation for Colposcopy (EFC) performance standards for the practice of colposcopy.

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Department of Obstetrics and Gynaecology, Klinikum Wolfsburg, Sauerbruchstr 7, 38440 Wolfsburg, Germany. Electronic address:
Department of Gynaecology and Obstetrics, Helsinki University Hospital, Finland and University of Helsinki, 00029 HUS, Finland.
Consultant Gynaecologist and Oncologist, Department of Obstetrics and Gynaecology, Betsi Cadwaladr University Health Board, Bangor, Gwynedd LL57 2PW, UK.
Laboratoire Cerba, 95066 Cergy Pontoise Cedex 9, France.
Consultant Gynaecologist, Department of Obstetrics and Gynaecology, University Hospital of North Staffordshire, Stoke-on-Trent ST4 6QG, UK.


A refinement of quality indicators (QIs) is described whereby the quality of care can be measured across colposcopy services in different countries and healthcare settings. A five-round Delphi process was conducted at successive satellite meetings from 2011 to 2015 of leading European colposcopists to refine the most high-scoring QIs relevant to colposcopic practice. A review and refinement of the wording of the standards and their criteria was undertaken by national society representatives. Six quality indicators were identified and refined. "Documentation of whether the squamocolumnar junction (SCJ) has been visible or not" was changed into "for cervical colposcopy transformation zone (TZ) type (1, 2 or 3) should be documented". The standard "percentage of cases having a colposcopic examination prior to treatment for abnormal cytology" was changed to "percentage of cases having a colposcopic examination prior to treatment for abnormal cervical screening test". The standard "percentage of all excisional treatments/conizations containing CIN2+ (cervical intra-epithelial neoplasia grade two or worse)" was changed into "percentage of excisional treatments/conizations having a definitive histology of CIN2+. Definitive histology is highest grade from any diagnostic or therapeutic biopsies". The standard "percentage of excised lesions/conizations with clear margins" was unchanged. The remaining two QIs define the minimum caseloads required for colposcopists. However, "cytology" was replaced by "screening results" to acknowledge the introduction of human papillomavirus testing to European screening programmes. Six QIs were identified to define good practice in colposcopy.


Colposcopy; Early detection of cancer; Healthcare quality assurance

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