Cervical cancer prevention and colposcopy in pregnancy: a nationwide survey of Italian colposcopists from the Italian Society of Colposcopy and Cervico-Vaginal Pathology

Managing cervical cancer prevention and colposcopy during pregnancy presents unique challenges. Despite existing literature on the topic, gaps in knowledge and inconsistent adherence to guidelines persist. This survey aimed to identify disparities in clinical practice, evaluate compliance with Italian and European recommendations, and assess the need for additional training among gynecologists and colposcopists. We conducted a nationwide, web-based cross-sectional survey among Italian colposcopists affiliated with the Italian Society for Colposcopy and Cervico-Vaginal Pathology. A 46-item questionnaire explored attitudes and practices related to cervical cancer screening, colposcopy, and diagnostic and therapeutic procedures during pregnancy. A comparative analysis was performed between junior and senior colposcopists. A total of 151 colposcopists completed the survey (response rate: 60.8%). While most supported screening during pregnancy, 17% considered endocervical brushing unsafe, and 14.5% questioned the reliability of screening tests. Colposcopy was universally regarded as safe; however, 96% described it as complex, and 87% recommended it be performed by experienced clinicians. Biopsies were typically limited to cases with suspected invasion, although 5% still reported performing endocervical curettage. Senior colposcopists demonstrated greater procedural confidence and adherence to guidelines, while junior practitioners expressed more concerns and were less likely to use pregnancy-specific informed consent. The survey showed a generally high level of adherence to current recommendations. Nevertheless, notable discrepancies remain, particularly in diagnostic approaches, informed consent practices, and pregnancy management. These findings highlight the need for targeted education and standardized protocols to support safe, evidence-based care during pregnancy.