1. Method
   • Triaging of abnormal cytologic, virologic, or clinical findings
2. Patient
   • Reduce fear
   • Build trust
3. Transformation Zone
   • Type 1: Squamocolumnar junction completely visible
   • Type 2: Squamocolumnar junction partly visible
   • Type 3: Squamocolumnar junction not visible
4. Normal Transformation Zone
   • Non-keratinizing squamous epithelium
   • Columnar epithelium
   • Ovulum Nabothi
   • Open cryps (glands)
5. Atypical Transformation Zone
   • Acetowhite epithelium
   • Mosaic
   • Punctation
   • Leukoplakia
   • Atypical vessels
6. Grading
   • Classification
     • NormalNo neoplasia
     • Minor changeCondyloma, CIN 1
     • Major changeCIN 2, CIN 3
     • CancerInvasive cancer
   • Pathognomonic Signs
     • Cuffed crypt (gland) openingsabsent vs present
     • Ridge signabsent vs present
     • Inner border signabsent vs present
     • Rag signabsent vs present
   • Graduating Signs
     • Color of acetowhite areathin vs dense
     • Dynamic of acetowhiteningslow vs rapid
     • Surface of mosaic or punctationfine vs coarse
     • Intercapillary distance of mosaic or punctationsmall vs large
     • Borderblurred vs well-defined
     • Iodine uptakepartial vs absent
7. Course of Examination
   • Inspection by using a self-holding speculum
   • Application of 5% acetic acid
   • Is the squamocolumnar junction fully visible (T-zone type 1, 2 or 3)?
   • Is there a typical or atypical transformation zone?
   • Application of grading criteria including application of 3% iodine
   • Where should a biopsy be taken from?
   • Which treatment should be done under magnification?

The rationale of colposcopy is defined by the ‘7 Rules’.

The nomenclature and implementation of colposcopy is described in the panel ‘Rules of Colposcopy’. The colposcopy rules 1-2-3-4-5-6(4-4-6)-7 contain the definition of colposcopy, guidelines for patient care, definition of the transformation zone including all features of its normal and abnormal morphology, the criteria for grading, and the steps of a complete colposcopic examination.

Rule 6 for grading is subdivided in a 4-4-6 nomenclature and is the essential part of the system.

Observing these rules, every clinician will become a good colposcopist. Following is a description of the various rules, which are the key issue of this panel. The nomenclature and principle of colposcopy is based on these rules. The colposcopist who strictly observes these rules stands a good chance of reaching a high level of proficiency after a short learning curve. In order to become an expert colposcopist, every examination session should include taking a biopsy and still images, or even better, video recordings. Both the colposcopist and pathologist should jointly evaluate the histologic sections. The ultimate goal of this collaboration is to allow the established link between colposcopic and histologic images become engraved in the mind of the colposcopist, who, as a result, should be able to determine the biology of a lesion with a high level of accuracy.