The present invention is an automated image analysis framework for cervical cancerous lesion detection. The present invention uses domain-specific diagnostic features in a probabilistic manner using conditional random fields. In addition, the present invention discloses a novel window-based performance assessment scheme for two-dimensional image analysis, which addresses the intrinsic problem of image misalignment. As a domain-specific anatomical feature, image regions corresponding to different tissue types are extracted from cervical images taken before and after the application of acetic acid during a clinical exam. The unique optical properties of each tissue type and the diagnostic relationships between neighboring regions are incorporated in the conditional random field model. The output provides information about both the tissue severity and the location of cancerous tissue in an image.