Approximately 15% of women in the NHS Cervical Screening Programme will have a smear that is reported as not being normal, 100 000 of whom will be referred for colposcopy each year. In addition to the colposcopic findings, assessment should include the clinical context and, in particular, the needs of the patient. In order to be able fully to take part in decision making, patients require accurate and relevant information about what is going on, and what their options are. These four cases illustrate this approach in a variety of cytological problems, where management is largely independent of the colposcopic findings.
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