OBJECTIVE:To estimate the quality o f community colpo-scopic practice in British Columbia through an assessment of the degree of correlation between colposcopy,cytology,and histology.METHOD:We reviewed a ll new -patient colposcopies in British Columbia du ring 2001by 37gyne-cologists in 24hospital -based clin ics.RESULTS:Col-poscopic impression closely mirrored the referral cytology diagnosis in 89.8%of cases.As with c ytology -biopsycomparisons,discordant cases were more likely to be overestimates of disease rather than underestimates,18.8%versus 1.8%.Overestimates we re usually biopsy sampling errors rather than false positive cytology.The overall correlation between cytolo gy and biopsy was con-sidered satisfactory in 79.4%of cases.Satisfactory a-greement between the colposcopic di agnosis and accompa-nying biopsies occurred in 86.8%of patients,five colpo-scopists had performance scores below this standard.Col-poscopy with a sensitivity of 90.3%a nd a specificity of57.3%as practiced in this provincia l program would ap-pear to be of a satisfactory level.The rate of intraepithelial or invasive disease increased from 40.6%in patients with low -grade squamous intraepithelia l changes to 91.9%in patients with suspicious or malignant cytology.The value of the colposcopic impression to ident ify disease correlated best with the higher the grade of dise ase predicted(64.6%to 92.6%).CONCLUSION:A measure of the colpo-scopic proficiency in the community can be estimated by comparing the level of agreement between the presenting cytology,colposcopic impression,and corresponding di-rected biopsies.The results of this study would indicate that 5individuals had practice stan dards that were below average.An integrated cytology -co lposcopy program fa-cilitates the assessment and identi fication of below -aver-age practice standards in a community. OBJECTIVE: To estimate the quality of community colpo-scopic practice in British Columbia through an assessment of the degree of correlation between colposcopy, cytology, and histology. METHOD: We reviewed a ll new -patient colposcopies in British Columbia du ring 2001by 37gyne-cologists in 24hospital-based clinics .RESULTS: Col-poscopic impression: closely mirrored the referral cytology diagnosis in 89.8% of cases. As with c ytology -biopsycomparisons, discordant cases were more likely to be overestimates of disease rather than underestimates, 18.8% versus 1.8 %. Overestimates we re usually biopsy sampling errors rather than false positive cytology. The overall correlation between cytolo gy and biopsy was con-sidered satisfactory in 79.4% of cases. Satisfactory a-greement between the colposcopic di agnosis and accompa-nying biopsies occurred in 86.8% of patients, five colpo-scopists had performance scores below this standard. Col-poscopy with a sensitivity of 90.3% a nd a specificity of 57.3% as practiced in this provincia l program would ap-pear to be of a satisfactory level. The rate of intraepithelial or invasive disease increased from 40.6% in patients with low-grade squamous intraepithelial l changes to 91.9% in patients with suspicious or malignant cytology. value of the colposcopic impression to ident ify disease correlated best with the higher the grade of dise ated predicted (64.6% to 92.6%). CONCLUSION: A measure of the colpo-scopic proficiency in the community can be estimated by comparing the level of agreement between the presenting cytology, colposcopic impression, and corresponding di-rected biopsies. The results of this study would indicate that 5 inddividuals had practice stan dards that were below average. An integrated cytology-co lcopy program fa-cilitates the assessment and identi fication of below - aver-age practice standards in a community.