Objective: to compare colposcopic findings to cytologic and histological diagnoses in women with colposcopic reports of ANTZ and/or HPV infection.

Methods: among 791 hospitalized women referred for colposcopic examination, colposcopy showed ANTZ grade 0-2 and/or HPV infection in 271 patients (34.26%). Only 153 were fully investigated by colposcopy, cytology (under colposcopic observation) and histology (target punch biopsy: 109 patients; surgical specimens of hysterectomy: 42 patients; conization: 2 patients). Cytological and histological diagnoses were reported according to the Bethesda System. Results: 132/153 Pap smears were estimable for sampling adequacy; 44/63 resulted as normal and were histologically positive for LSIL. Five LSIL-positive Pap tests were negative on histology (false negative and false positive rate of 33.33% and 3.78%) The pap test was diagnostic for intraepithelial neoplasia in 34/65 cases (53.3%) and for invasive cancer in 6/11 cases (54.5%). In 67/132 cases (50.8%) adequate-for-sampling Pap smears could not predict the exact diagnosis. On the other hand, 108/141 patients with colposcopic evidence of ANTZ/cancer showed histological SIL or invasive neoplasm (76.59%): ANTZ I was associated to LSIL and HSIL in 74.1 % and 2.4%; ANTZ 2 to LSIL, HSIL and invasive cancer in 41 %, 30.76% and 10.3%. Colposcopic suspi­cion of invasive cancer in 8 patients was histologically demonstrated in 7 (87.5%); colposcopic diagnosis of HPV infection was confirmed in 10/12 (83.4%). Conclusion: a better correspondance was shown between colposcopy and histology than between cytology and histology in the diagnosis of SIL. We suggest a routine colposcopy investigation for all patients admitted to a gynecological clinic and we believe it is very important to take Pap smears under colposcopic observation if colposcopy and cervical smears are performed in the same sitting.