QUALITY ASSURANCE IN COLPOSCOPY WITHIN AN CERVICAL CANCER SCREENING PROGRAMME: IMPLICATIONS OF EUROPEAN GUIDELINES FOR LITHUANIAN PRACTICE

Abstract

Summary. Human papillomavirus-based cervical cancer screening changes the role of colposcopy within an organised screening programme. Colposcopy should not be regarded as an isolated technical procedure or simply as visual examination of the cervix under magnification. It is a specialised diagnostic process in which colposcopic findings are interpreted in the context of the screening programme algorithm, cytology results and, where applicable, HPV testing, while further clinical management is guided by biopsy and histological findings. European quality assurance guidelines for cervical cancer screening, the European Federation for Colposcopy and ESGO–EFC consensus documents emphasise that colposcopy should be performed by specialists with documented training, sufficient practical experience and participation in quality assurance activities. High-quality programme-based colposcopy requires appropriate equipment, standardised documentation of findings, the ability to perform targeted biopsy, reliable linkage with histopathology, result tracking, multidisciplinary discussion and audit of quality indicators. This article reviews the main principles of colposcopy quality assurance described in European documents and discusses their practical relevance for the Lithuanian cervical cancer screening programme. It is emphasised that access to colposcopy services should be improved by enabling providers to meet quality requirements, rather than by lowering standards for competence, documentation, audit or equipment.