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Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0000000000000069
Original Articles - Cervix and HPV

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

Open Access
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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.

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


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