“The term “cervical erosion” has been used in obstetrics and gynecology to diagnose chronic cervicitis for more than a hundred years, from 1850 to the 1980s of the last century. With the progress of medical science, especially the in-depth research on the etiology and pathogenesis of cervical cancer and its precancerous lesions in the past 10 years, a large number of evidence-based medical research results have been obtained worldwide, indicating that persistent infection (at least for more than 2 years) with about 15 types of oncogenic human papillomaviruses (HPVs) is closely related to the development of cervical cancer and its precancerous lesions. Celiac disease, which was once thought to be related to cervical cancer, is now thought to be unrelated to the development of cervical cancer. In the 1980s, the American monographs and textbooks on obstetrics and gynecology deleted the term “cervical erosion” and replaced it with “cervical ectopy”. Our country also in recent years revised the publication of obstetrics and gynecology textbooks will be discarded. Unfortunately, to date, there are still many obstetricians and gynecologists in China who continue to use the term “cervical ectopy”, providing unnecessary treatment and causing harm to women who have cervical ectopy but no cervical disease. What is the nature of “celiac disease”? Domestic textbooks used to describe “celiac disease” as a congested, red, granular appearance of the outer cervix. There are two types of cervical epithelium during embryogenesis: primitive squamous epithelium and columnar epithelium. Before puberty, the primitive squamous-columnar junction is located anywhere within or outside the cervical canal or the vaginal vault. After puberty, under the influence of estrogen, the cervix grows rapidly and greatly exceeds the body of the uterus, and cervical ectropion occurs. Ectropion exposes the columnar epithelium of the cervix to the ectocervix, which is “red and rough”: red because the columnar epithelium is arranged in a single layer with a rich network of blood vessels underneath; rough because the columnar epithelium is fused with each other in the form of villi or granules. In the past, the term “celiac disease” was used to describe the “red roughness” of the ectocervix, which was mistakenly described as “loss of the overlying epithelium”, which is an inappropriate and erroneous terminology that should be abandoned. The essence of “celiac disease” is cervical ectropion, a physiologic phenomenon that lasts from puberty to decades to come. Second, “celiac disease” – cervical transformation zone and squamous epithelial chemosis The cervical covered epithelium from the cervical canal to the outside of the cervix in the following order: columnar epithelium, chemosis epithelium and primitive squamous epithelium. The outer portion of the cervical canal is often the area of the transformation zone (TZ) of the cervix. The transformation zone is composed of active chemotaxis. 1, cervical columnar epithelium outside and squamous epithelium: it is known that estrogen effect on the cervix, can make the columnar epithelium from the cervical canal to move to the outside of the cervical canal. When the columnar epithelium is exposed to the acidic environment of the vagina, it causes the reserve cells located underneath the columnar epithelium to be exposed, proliferate, differentiate, and then form a thin, multilayered pseudocomplex (i.e., chemotaxis). This physiological process of transformation from cervical columnar epithelium to squamous epithelium is called squamous epithelial chemotaxis, which takes about 1-3 weeks and is irreversible. Over 60% of the columnar epithelium in a woman’s lifetime undergoes squamous metaplasia. 2. Recent studies have shown that the cervix’s pyogenic epithelium is particularly susceptible to oncogenic HPV! However, the reason for this is unknown. This explains why the vast majority of cervical cancers and their precancerous lesions are located within the transformation zone rather than outside. 3. Type of transformation zone and anatomical location of cervical lesions: The cervical transformation zone changes dynamically (i.e., moves up and down) throughout a woman’s life. Embryonic period (the role of placental hormones), puberty, pregnancy or long-term oral contraceptives in women, the transformation zone is located in the cervical canal (the old term “cervical erosion”), the squamous epithelium within the very active chemotaxis. In order to determine the anatomical location of the cervical lesions, three types of transformation zones are recognized colposcopically: Type I transformation zone (satisfactory colposcopy): the transformation zone is located entirely outside the cervical canal. Type II transformation zone (unsatisfactory colposcopy): the transformation zone is partially located outside/partially inside the cervical canal. Type III transformation zone (unsatisfactory colposcopy): the transformation zone is located entirely within the cervical canal. CIN or cervical cancer is most often located within the transformation zone. The purpose of identifying the type of transformation zone is to determine whether the cervical lesion is located inside, outside, or both inside and outside the cervical canal? Understanding the type of cervical transformation zone and the mechanism of squamous epithelial chemotaxis is very useful basic knowledge for clinicians to recognize the pathophysiological changes in the cervix and make differential diagnosis of cervical diseases. Third, the treatment of “cervical erosion” what are the hazards? Over the past few decades, China has advocated ironing, laser, freezing and other physical treatments for moderate and severe cervical erosion. In recent years, the LEEP (Laparoscopic Electrosurgical Excision of the Cervix) technology, which is specially used for the treatment of cervical pre-cancerous lesions (CIN) in western developed countries, has also been used for the treatment of cervical celiac disease. Driven by economic interests, this treatment has a tendency to further expand, which is very worrying! What are the dangers of treating “cervical erosion”? First of all, it is against medical ethics to treat “celiac disease”, as the women being treated may not have cervical disease, and it is unethical to bring physical and mental burden and economic loss to women because of the treatment! Secondly, treatment without cervical screening may miss invasive cervical cancer or high-grade pre-cancerous lesions (CIN3/AIS), which is dangerous for women with the disease. In addition, the treatment may cause the following harms, such as: adhesion or atresia of the external cervical os, trauma leading to “cervical inflammation” or “endometriosis of the cervix” causing post-coital bleeding or prolonged leukorrhea, impaired cervical function leading to miscarriage or preterm labor in pregnancy, and so on. People have known cervical cancer for more than 200 years, and in underdeveloped countries and regions, cervical cancer is the most common malignant tumor. In most areas of China, due to limited medical conditions, clinicians are accustomed to determine whether the cervix is diseased or not by visual observation only. Only a few invasive cervical cancers can be recognized by naked eyes. Typical invasive carcinoma of the uterine cervix has abnormal anatomical appearance, with irregular or cauliflower-shaped cervix due to disordered growth of cancerous tissues, and the surface of the cervix is often accompanied by loss of the overlying epithelium (i.e., true erosions: its pathological significance is consistent with superficial ulcers) or erosive, cavitary ulcers, and the cervical surface is often hemorrhagic or contact with bleeding, etc. On the contrary, the appearance of smooth uterine cervix is not smooth, but it is smooth and smooth, and the surface of the cervix is smooth and smooth. In contrast, a smooth-appearing cervix was generally recognized as healthy. These perceptions, revisited with today’s evidence-based medical thinking, are false. It is often difficult to determine the presence or absence of cervical disease by visual observation alone. The diagnosis of precancerous cervical lesions is based on the “three-step technique” Invasive carcinoma of the cervix originates from the squamous or glandular epithelium of the cervix. The early stage of its natural history is the persistence of high-risk HPV infection, which leads to the slow destruction of the maturation and differentiation process of the epithelium in the migratory zone of the cervix, and this early stage is known as cervical precancerous lesion. The primary method of screening for cervical cancer is cervical cytology, supplemented by high-risk HPV DNA testing. The diagnosis of cervical cancer and high-grade precancerous lesions (≥CIN2/AIS) is based on the “three-step technique”: cervical cytology, colposcopy and histopathology. There is only one treatment for high-grade precancerous lesions: excision of the entire lesion. The focus of cervical cancer prevention and treatment is on early detection and standardized treatment of cervical cancer and its high-grade precancerous lesions.