Share this article on:

Utility and Reproducibility of the International Federation for Cervical Pathology and Colposcopy Classification of Transformation Zones in Daily Practice: A Multicenter Study of the German Colposcopy Network

Luyten, Alexander MD1; Buttmann-Schweiger, Nina MPH2,3; Hagemann, Ingke MD4; Scherbring, Sarah MD5; Boehmer, Gerd MD6; Gieseking, Friederike MD7; Woelber, Linn MD, PhD7; Glasenapp, Frank MD8; Hampl, Monika MD, PhD9; Kuehler-Obbarius, Christina MD10; van den Bergh, Marcus11; Petry, Karl Ulrich MD, PhD1; For the German Colposcopy Network (G-CONE) and the German Colposcopy Study Group

Journal of Lower Genital Tract Disease: July 2015 - Volume 19 - Issue 3 - p 185–188
doi: 10.1097/LGT.0000000000000069
Original Articles - Cervix and HPV

Objective: To compare the distribution of International Federation for Cervical Pathology and Colposcopy (IFCPC) transformation zone (TZ) types among women in different age groups referred to 8 colposcopy clinics.

Materials and Methods: Between February 2012 and February 2013, we prospectively collected individual patient data from 8 clinics within the German Colposcopy Network (G-CONE). Data were analyzed using ODSdysplasie, software designed to allow continuous quality assessment in colposcopy clinics. The distribution of IFCPC-classified TZ was compared between different centers for the following age groups: younger than 30 years, between 30 and 50 years, and older than 50 years.

Results: Of 3,761 patients included in the analysis, 2,153 (57%) were classified as having type 2 TZ, 906 (24%) as type 1 TZ, and 702 (19%) as type 3 TZ. Type 3 TZ was the most commonly reported type in women older than 50 years (70%). We found that the relative distribution of type 3 TZ between age groups was similar in the participating colposcopy clinics. However, there was evidence of heterogeneous distribution of types 1 and 2 TZ between age groups in different clinics, ranging from 7.8% to 66.4% for type 1 TZ in women younger than 30 years and 28.9% to 78.1% for type 2 TZ in women 30 to 50 years old.

Conclusions: Although IFCPC type 3 TZ seems to be a reproducible finding, the distribution of types 1 and 2 TZ showed significant heterogeneity. A more precise anatomic distinction between types 1 and 2 TZ in the IFCPC terminology could improve reporting of colposcopy findings.

Distribution of type 3 TZ between age groups is similar in different colposcopy clinics, but better differentiation of types 1 and 2 is required.

1Klinikum Wolfsburg, Department of Obstetrics and Gynecology, Sauerbruchstr, Wolfsburg; 2German Centre for Cancer Registry Data, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin; 3Cancer Epidemiology, University Cancer Center Dresden, Technische Universität Dresden, Dresden; 4Partnerschaftsgesellschaft abts+partner Prüner Gang, Kiel, Germany Deutsche Klinik; 5Gynäkologische Gemeinschaftspraxis, Karrenführerstraße, Braunschweig; 6Institute for Cytology and Cytology, Theaterstr, Hannover, Germany, 7University Medical Center Hamburg-Eppendorf, Department of Gynecology, Martinistraße, Hamburg; 8Frauenarztpraxis, Am Herzogenkamp, Bremen; 9University Düsseldorf, Clinic for Gynecology and Obstetrics, Moorenstr, Düsseldorf; 10Frauenarztpraxis, Heussweg, Hamburg; and 11Asthenis GmbH, Aschheim, Germany

Reprint requests to: Karl Ulrich Petry, MD, PD, Department of Obstetrics and Gynecology, Klinikum Wolfsburg Sauerbruchstr. 7 38440 Wolfsburg, Germany. E-mail:

The authors have declared they have no conflicts of interest.

This study was financially supported by “Studiengruppe Kolposkopie e.V.”

A.L. has received speaker’s honorarium from Qiagen and BD diagnostics. K.U.P. received speaker’s honorarium from BD, Roche, GSK and is a board member of Roche diagnostics. A.L. and K.U.P. are currently receiving institutional grants from Sanofi-Pasteur MSD. M.v.d.B. is CEO of asthenis GmbH and is patent owner of the documentation program “ODSdysplasie”. For the remaining authors, no conflicts of interest were declared.

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Copyright © 2015 by the American Society for Colposcopy and Cervical Pathology