Editorial Introduction
Thomas F. Purdon, MD, FACOG

With this edition of Trends in Cervical Health, the editors are please to announce that a new series of contributions by V. Cecil Wright, MD, FRCS(C), FACOG will appear in this and future editions. Dr. Wright is a gynecologic oncologist and now Professor Emeritus from the department at the University of Western Ontario. He has made many major contributions to the literature and many significant contributions in the field of colposcopy. He has developed many CDs and atlases on diseases of the cervix, vulva, and vagina, and received a Distinguished Scientific Achievement Award from the ASCCP.

 

Case Study
Kenneth D. Hatch, MD

This case report illustrates the colposcopic and histologic findings of human papilloma virus (HPV) and cervical intraepithelial neoplasia (CIN) in a 27-year-old woman whose cytology was reported as atypical squamous cells, cannot rule out high grade neoplasia (ASC-H).

Colposcopic Appearances of Glandular Disease
V. Cecil Wright, MD, FRCS(C), FACOG

This pilot article to our new Master Colposcopy series highlights the varying appearances of cervical glandular lesions. Problems recognizing cervical glandular lesions arise because of imperfect cytology (i.e., cytology not indicating a glandular lesion); colposcopic inexperience with glandular lesions; location of lesions (endocervical canal versus ectocervix); disease buried under metaplastic or dysplastic epithelium; and the many conditions that mimic glandular lesions.



Interpreting Blood Vessel Patterns In Colposcopy
V. Cecil Wright, MD, FRCS(C), FACOG

Blood vessel patterns are diverse. At colposcopy, they are best studied using a variety of magnifications before the application of acetic acid (which hides them) and with the blue/green filter (which accentuates them). Their characteristics are extremely valuable for identifying the different benign and diseased entities and differentiating between colposcopic mimics. Differentiating colposcopic presentations from heir mimics requires an understanding of blood vessel patterns. Studying them is an essential exercise.

Stigma, Misconceptions Impede Chlamydia and Gonorrhea Screening
Fred Wyand and Deborah Arrindell

Chlamydia and gonorrhea infections are often unrecognized and undiagnosed; estimates place the true incidence of chlamydia in the United States at nearly 3 million cases and over 700,000 gonorrhea infections are estimated to occur each year. The highest rates with both infections occur in young people, with females ages 15-24 years bearing the heaviest burden.
Federal and professional recommendations call for annual chlamydia screening for all sexually active women age 25 and younger, and chlamydia and gonorrhea screening for women with risk factors. In spite of this, screening rates with both chlamydia and gonorrhea remain low. Why aren’t more individuals screened, especially those most at risk?