Manual on Cervical Cytology and Colposcopy Radhika N Joshi
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1Manual on Cervical Cytology and Colposcopy2
3Manual on Cervical Cytology and Colposcopy
Radhika N Joshi MBBS DGO DFP FICOG Yashomangal Cytology and Cervical Cytology Clinic FOGSI Training Center for Cervical Cytology and Colposcopy Kolhapur, Maharashtra, India E-mail: drnandujoshi@yahoo.com Foreword Usha B Saraiya
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Manual on Cervical Cytology and Colposcopy
First Edition: 2015
9789351527640
Printed at
5Foreword
It is with great pleasure that I write foreword for a “Manual on Colposcopy”.
Colposcopy has been gaining ground in the clinical practice of gynecology in India. In the last two decades, emphasis has been placed on the early detection of cervical cancer and precancer. There are many patients who come with a report of abnormal Pap smear or a VIA +ve when visual inspection with acetic (VIA) acid is used as a screening test. All these women will need a colposcopic evaluation.
The clinician is the key person in the prevention of invasive cervical cancer. At the time of colposcopy, if proper steps are followed, the clinician can judge fairly accurately how far the disease process has progressed, whether biopsy is indicated also whether some simple treatment can be given. Further, the clinician can judge the general health of the patient and correlate with the history as also the personal life history. The patient should go away reassured and with positive guidelines on what to do next.
I must congratulate the author on describing the procedure stepwise, with clear-cut instructions on the techniques used. The manual will be needed by the side of the colposcopy trolley so as to overcome some of the difficulties encountered in the day-to-day practice.
Since the beginning of the 21st century, many new concepts have been introduced in the field of preventive oncology. The process of carcinogenesis is much better understood. It is now possible to arrest the process of carcinogenesis in cervical cancer and promote its reversal. The knowledge of human papilloma virus (HPV) as the causative organism has led to the development of HPV-DNA testing and the use of HPV vaccines. We live in interesting times and look forwards to further research in the subjects.
Finally, a book is meant for Readers. We hope there will be many Readers who will find this book interesting and pleasurable to read. We also hope that the knowledge gained will translate into better clinical practice and alleviate human suffering.
I send my “Good Wishes” to the Author, the Publishers and above all to all the Readers. Your joint efforts will certainly reduce the burden of invasive cervical cancer in India. Moreover, it will lead to “empowerment of women through health”, which is our ultimate goal.
Usha B Saraiya
MD DGO FIAC FICS FICOG
Consultant Obstetrician and Gynecologist
Sir HN Hospital, Breach Candy Hospital, Saifee Hospital, Mumbai, Maharastra, India
Consultant Oncologist at Cama and Albless Hospital, Mumbai, Maharastra, India
CT Hsu Orator 2002 in Bengaluru
Outstanding Woman Obstetrician and Gynecologist at FIGO 2003
Editor for India for Journal of Obstetrics and Gynaecology and Research (AOFGO Journal)
Advisor in Gynecologic Oncology, Bangladesh Institute of Cancer Research
Chairman: Indian College of Obstetricians and Gyaecologists
Past President of FOGSI 2002
Past President of Mumbai (MOGS) 97–986
7Preface
I am happy to present the 1st edition of Manual of Cervical Cytology and Colposcopy in reader's hand.
As I am conducting the FOGSI recognized courses, many trainees asked me many practical problems. Even after that the practitioners when they go back to their clinics and start actual work, they may come across many small, simple problems. This manual is there to help them out in taking Pap smears, performing visual inspection of cervix, cytology and colposcopy. Interpretation of the reports and management is another field which we as clinicians will have to understand in detail. This manual will give you all practical details.
My special thanks to consulting pathologists Dr PV Purohit from Kolhapur for supplying me histopathological appearances of the biopsies, my friend Dr Rohini Limaye, Gynecologists, Kolhapur, and Dr Monali Joshi for proofreading, and Mrs Amruta Patil for helping me to prepare this manual.
Radhika N Joshi8
9Synopsis
Cervical Cancer is still the common cancer of women in India. WHO declared it as a preventable disease but it is not prevented. We have to have extensive screening program to control the disease. Early detection should continue at all levels. Visual inspection, Pap smears, colposcopies, HPV testing and vaccination should be available at all gynecological clinics. FOGSI thought of starting various training centers for cervical cytology and colposcopy, and ours is the first recognized training center all over India. More than 200 gynecologists have already taken training in this center.10111213