Recent innovations in colposcopy practice.

Colposcopic practice continues to evolve. As its need has expanded, so has the role of training, audit and continuing medical education. The recently published National Health Service Cervical Screening Programme clinical guidelines document covers almost every aspect of clinical practice in an evidence-based directory. Excision of the transformation zone (TZ) may be a very minor or major entity. The recent TZ classification system of the International Federation of Cervical Pathology and Colposcopy attempts to clarify and standardize nomenclature so that therapy can be realistically compared. The role of human papillomavirus (HPV) in clinical practice continues to be controversial and has not yet found a place in the UK. For the evaluation of borderline nuclear abnormal smear and for post-treatment surveillance, HPV is clinically useful and efficient. Other biological tumour markers are likely to become clinically useful as their predictive profiles emerge.