Foreword

This book is not a textbook of colposcopy. Nor is it a textbook of histopathology of the uterine cervix and vagina. It is for these reasons that it contains neither theory, statistics nor bibliography. It aims simply to be a manual, a guide providing gynaecologists with basic knowledge to enable them to learn colposcopy alone.

A major place is given over to dysplasias and carcinomas and, among the latter, to occult carcinomas and small carcinomas. Colposcopy is the key examination in the diagnosis and treatment of dysplasias but surface dysplasias may hide sub-clinical carcinomas which may have serious clinical consequences if they remain unrecognised.

I wish to express my thanks to those who enabled me to learn colposcopy. I was first given a colposcope by René Musset almost forty years ago. Whilst the partisans of colposcopy on the one hand and cytology on the other were confronting each other, he made efforts to show that these two methods were complementary rather than competitive. Time has shown that he was right.

Through his Atlas, Gustave Mestwerdt guided my beginnings in colposcopy. René Moricard taught me how to read a histological section, to avoid hazardous interpretations and not confuse coincidence with cause. Violette Nuovo taught me that certain lesions might be missed by a colposcopist unaware of the results of smears.

This book summarises the teaching that I have given: first in the department of Profes­sor René Musset at the Hôtel-Dieu Hospital in Paris, and later in my own laboratory. This teaching has taken shape and been modified with the passing years, as a result of dis­cussions with participants. Teaching is not only a duty. It is also the pleasure of handing on one’s own knowledge to others. But, above ail, it is the best way to learn. I offer sincere thanks to the hundreds of students who, by their questions and criticisms, have forced me to reflect and to attempt to explain. Their enthusiasm and thirst for knowledge, intact after so many years of study, have encouraged me to pursue my aim: the training of colposcopists capable of understanding what they see and of taking therapeutic decisions.

In my daughter, Dr Isabelle Cartier, I have found one of my best and dearest students. She has been brought up with colposcopy and her capabilities in the field are a matter of great pride to me. Very early in her career she devoted much time and effort to the study of the evolution and development of dysplasia. Writing this third edition with her has brought a new breadth and depth of understanding to me in many areas of study. I am much in her debt for her assistance and inspiration.

In the first edition of this book, Roussel Laboratories permitted the use of photographs which had been published in the third Atlas d’endoscopie Roussel, which came out in 1974. Their interest has greatly contributed to the publication of this book. Thanks are also due to Mrs Michelle Casties and Mr Michel Politur who designed the book, to the technicians and cytotechnicians of my own laboratory, who prepared and photographed the cytological and histological preparations.