title: Factors That Virtually Exclude Cervical Cancer at Colposcopy.
abstract: OBJECTIVE
  The objective of this work was to determine the risk of invasive cervical cancer at colposcopy based on the woman's age, associated cervical cytology, and colposcopic impression.
  
  
  METHODS
  Review of electronic medical records from colposcopy clinics followed by chart review of women with cervical cancer.
  
  
  RESULTS
  Between March 1, 1996, and April 23, 2013, 27,381 cervical colposcopies for evaluation of abnormal cervical cytology and/or positive high-risk human papillomavirus tests were performed. Median age at colposcopy was 32 years (range, 11-91 years). Biopsy at colposcopy or at subsequent loop electrocautery excision procedure, cervical conization, or hysterectomy diagnosed cervical cancer in 0.5% (132/27,381) of women. At colposcopy, the risk of cervical cancer for women younger than 30 years was 0.07% (8/12,131), for women with Cytology-Lo (low-grade squamous intraepithelial lesion, atypical squamous cells of uncertain significance, benign endometrial cells, or negative), it was 0.17% (43/25,779); and for women with normal colposcopic impressions, it was 0.17% (18/11,389). The risk of cervical cancer for women younger than 30 years with Cytology-Lo was 0.01% (1/11,663).
  
  
  CONCLUSIONS
  At colposcopy, cervical cancer is not excluded by a normal colposcopic examination result, Cytology-Lo, or age younger than 30 years, but is virtually excluded by the combination of age younger than 30 years and Cytology-Lo.
authors.affiliation: 1Deparment of Obstetrics and Gynecology, Southern California Permanente Medical Group, Fontana, CA, USA; 2Preventive Oncology International, Cleveland Heights, OH and Women's Health Institute, Cleveland Clinic, Cleveland, OH; and 3Department of Research and Evaluation, Southern California Permanente Medical Group, Los Robles, Pasadena, CA.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Pretorius
authors.forename: Jerome L
authors.initials: JL
authors.lastname: Belinson
authors.forename: Patricia
authors.initials: P
authors.lastname: Peterson
authors.forename: Raoul J
authors.initials: RJ
authors.lastname: Burchette
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003127:Colposcopy / Q000379:methods*; D003584:Cytological Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D055815:Young Adult