Correlating Papanicolaou Smear, Colposcopic Impression, and Biopsy (original) (raw)

2001, JOURNAL OF LOWER GENITAL TRACT DISEASE

Objective: To determine associations among cervical cytology, colposcopy, and biopsy in women with HIV. Methods: HIV seropositive women and uninfected comparison women in a multicenter prospective cohort study underwent colposcopy for protocol indications. Women were eligible if they had satisfactory cytology, a cervix, and colposcopy between October 1, 1994, and September 30, 1999. Cytology, colposcopic impression, and biopsy were compared using equivalent categorizations. Kappa statistics with bootstrap sampling assessed strength of associations. Results: Data were contributed by 1370 HIV seropositive women, with colposcopy in 978 (71%), and by 224 seronegative women. Biopsies were performed on 603 (44%) seropositive women at least once during 1015 colposcopy visits and on 82 (37%) seronegative women at 116 visits. The positive predictive value of cytology was 619/854 (72%) for seropositive women, [kappa = 0.31 (95% C.I. = 0.28, 0.34)], and 39/65 (60%) for seronegative women, [kappa = 0.09 (0.01, 0.16)]. The positive predictive value of colposcopy was 512/720 (71%) [kappa = 0.11 (0.08, 0.14)] for seropositive women and 44/80 (55%) [kappa = -0.03 (-0.11, 0.05)] for seronegative women.