LAUSR

W e read with interest the commentary by Bogliatto and Bornstein regarding the 2017 ASCCP Terminology for Colposcopic Practice. The 2017 ASCCP terminology was developed as one component of the ASCCP Colposcopy Standards effort by an expert workgroup and ratified by the ASCCP Colposcopy Standards Committee composed of expert colposcopists from around the United States. Before this effort, no uniform terminology was recommended and used in the United States. There was a need for a practical, clear, consistent, and useable set of criteria for colposcopists practicing in the United States. The underlying terminology would optimally describe colposcopic findings with the following: a) clarity—terms clearly defined, with minimal ambiguity, meaningful to all, that reflect underlying biology; b) reproducibility—terms that mean the same when applied by the same person across time (intraobserver) and by different individuals (interobserver); c) comprehensiveness—terms that incorporate all clinically relevant criteria; d) simplicity and practicality—terms that represent a minimal set required to communicate findings to other colposcopists, without clinically irrelevant features. We agree with Bogliatto and Bornstein that it would be ideal to have the same uniform colposcopy terminology everywhere in the world, and adopting the 2011 International Federation for Cervical Pathology and Colposcopy (IFCPC) terminology was discussed by the Colposcopy Standards working group. It was found that while the 2011 IFCPC terminology fulfilled some of the outlined criteria, for example, comprehensiveness, it did not meet some of the other criteria, like reproducibility and simplicity/practicality. Even more importantly, the majority of colposcopists in the United States do not currently use the IFCPC terminology, despite its introduction several years ago. We therefore embarked on a process to define a uniform terminology for the United States that would have larger uptake and that was compatible with the IFCPC terminology. The result is an adapted and simplified version of the 2011 IFCPC terminology. Some of the confusion regarding the IFCPC terminology stems from the term adequate versus inadequate to describe cervix visibility, a term that we have tried to abandon for describing