Is biopsy necessary for colposcopy?

Colposcopy and biopsy are very common gynecological examination methods. Colposcopy or biopsy is required when diagnosing many diseases. However, many women do not understand this examination. When they hear about the need for a colposcopy or biopsy, they are very scared and even worry that these two examinations will damage their health. Some women have misunderstandings about colposcopy and biopsy, and usually believe that a biopsy is necessary for a colposcopy.

Is a biopsy necessary for colposcopy?

Colposcopy does not necessarily require a biopsy, which is usually performed when a lesion has already been found. If the doctor observes with the naked eye and finds no erosion, polyps, etc., a biopsy is not required. Otherwise, further biopsy is required.

A colposcopy can detect cervical lesions, especially for patients with high-risk HPV positive infection, who often need further colposcopy to make a clear diagnosis. If the examination results are not ideal, cervical cells need to be taken for pathological research to see if there are cervical precancerous lesions and the possibility of cervical cancer.

In addition, colposcopy is usually performed three days after the menstrual period has completely stopped.

Colposcopy is a screening method and biopsy is a confirmatory method. Colposcopy can observe the morphological structure of the vascular epithelium on the surface of the cervix to evaluate local cervical lesions. The situations in which a colposcopy is needed include: cytology examination showing ASC-US combined with high-risk HPV DNA infection, or LSIL and above; HPV infection types 16 and 18; colposcopy before cervical conization to determine the extent of resection; and gynecological examination for suspected diagnosis of vulvar, vaginal and cervical lesions.

If the cytology test is negative and the HPV infection is high-risk, but not type 16 or 18, a colposcopy is not required. It can be treated by observation or topical medication for 3-6 months, and TCT and HPV should be rechecked after stopping the medication for 1 month. If the high-risk HPV infection is types 16 and 18, further colposcopy is required regardless of whether the cytology test is negative or positive.

Biopsy is the process of taking local tissue for pathological examination, which is a means of diagnosing cervical cancer. For patients with ASC-H and LSIL, colposcopy and biopsy are required. For patients with HSIL, colposcopy and biopsy are also required, and cone biopsy can also be performed if necessary.