The goal of this proposal is to address three areas of the female reproductive tract which are inadequately diagnosed resulting in a large economic impact and high morbidity for women. We propose assessing the emerging technologies of optical spectroscopy, confocal microscopy, optical coherence tomography, and nuclear karyometry for the diagnosis of these entities. These optical signals will be correlated with the molecular and genomic changes in the three gynecologic organ sites and the technology will be assessed for accuracy, safety, reliability, cost-effectiveness, and acceptability. Clinical problems addressed with this proposal include the inability to accurately identify ovarian cancer in an early and therefore more curable stage, the inability to identify endometrial hyperplasia that will not progress to cancer and thus can be treated conservatively, and the accurate detection of preterm labor. Improving assessment of these entities would increase the survival from ovarian cancer, avoid unnecessary surgery for endometrial hyperplasia, and detect those women with true preterm labor. Women’s health could be vastly enhanced by technologies which improve and automate diagnosis, and decrease cost.