Quality control is mandatory in a cervical cancer screening programme, including colposcopy. Nowadays, we often hear that blind four-quadrant biopsies, after an abnormal Pap test, give better results than colposcopic evaluation. Lack of quality control can explain the poor 50% of correlation between colposcopy and blind multiple biopsies. In Canada, quality control in colposcopy was initialed as early as 1973 and over the years, colposcopic impression mirrored the referral cytology diagnosis in 90% of the cases. Quality control should cover the following: training of colposcopists, indications for referral, number of new consultations annually, types of treatments, correlation between colposcopy impression and histopathology results. When a colposcopist does not meet the standard, training sessions should be mandatory.Since HPV vaccination programmes are in place, there will be fewer references for high grade lesions. Quality control will be more important.
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