Like Hippocratic Oath, Dr. Stafl was an ambitious physician who tried to save women from disease and
eventually striking cervical screening method, ‘Cervicography’ was developed by his attempt to save women
from cervical cancer in 1981.
The best way to protect oneself from disease is prevention before disease occurs. Cervical cancer is also
preventable by screening such as Pap smear which had been known as the most efficient screening method.
Yet 30~50% of Pap smear result is still false-negative. Consequently adjunctive test has been required to
compliment defect of Pap smear.

Dr. Hinselmann from Germany thought that cervical cancer develops from tiny tumor and a close –up look of
tumor will help to find out the beginning of the disease. Therefore he developed a cervical cancer specialized
magnification called ‘Colposcopy’ and when colposcopy combined with Pap smear, it showed dramatic
percentage of accuracy which was more than 98%. However the price of colposcopy itself was too high and
required special skill to manipulate it hence not suitable for screening test.

Dr. Stafl however thought differently that he applied the benefits and principle of colposcopy yet developed
simpler version of colposcopy, ‘Cervicography’. Cervicography takes images of cervix and magnify up to 50 times
and evaluate the status of cervix. Dr. Stafl even developed special camera for Cervicography with NTL World-wide
in Missouri in USA and Cervicography was spread over the country for mass screening of cervical cancer.

700 women participated for a study of clinical accuracy of cervical cancer screening methods – Colposcopy, Pap
smear and Cervicography. Result of the study was published by American Journal of Obstetrics & Gynecology (1).
The result of Cervicography was outstanding. Biopsy test was followed for 296 women with positive result from
Pap smear and 136 women had atypical dysplasia or carcinoma and Cervicography detected 91.1% of them.
Moreover, according to Dr. Spitzer Jones (2) paper, Cervicography detected carcinoma in situ with accuracy of 81%.

Evaluation of Cervicography introduced by Dr. Stafl got excellent rating. Unlike Colposcopy, which only can take
4-5 patients per hour, Cervicography allowed more than 100 patients for cervical cancer screening per hour and
Cervicography was used as an educational tool for Colposcopy and introduced in OBGY text books.
Later on, Cervicography was introduced to other countries and the result of clinical study of Cervicography was
continuously reported.

In 1989, famous Colposcopy specialist Dr. Michael Campion also introduced the benefits of Cervicography and
consequently Cervicography was even introduced in Nurse Practitioner Forum in following year. Clinical study
from UK in 1991 stated that Cervicography improved the high false-positive rate of Pap smear. In 1993, a clinical
study from Yugoslavia also emphasized the superiority of Cervicography with sensitivity of 89% and specificity of
92 when Pap smear only showed 52% of sensitivity and 94% of specificity. In ASCCP held in Chicago
Cervicography was announced and many physicians from other countries were apprised of clinical research of
Cervicography.

In 1994, National Cancer Institute in USA also had a research on Cervicography and its sensitivity was 94%.
Also a large-scale clinical study was conducted in France with 1539 women and result was concluded that
Cervicography is the ideal adjunctive test for Pap smear.

In South Korea, Cervicography was introduced through National Testing Laboratories Asia (Current NTL Medical
Institute) and in 1998, a clinical paper was published with a title of ' The role of Cervicography in cervical cancer
screening in Korean women'. Like other results published in other countries, sensitivity of Cervicography was
96.6%. Clinical papers concluding the benefits of Cervicography was constantly published.

As a result, Cervicography was involved in Korean national cancer program. Consequently many clinical research
of three combined test- Pap smear, Cervicography and HPV were conducted.
In 2006, clinical result from the 18th International OBGY conference reported that Cervicography showed 85% of
sensitivity and when combined with Pap smear, sensitivity increased to 93%. According to 2013 Oncology report,
high sensitivity of combined test of Cervicography and Pap smear still remain as 98.1% (9).