A comparative Study to Assess the Accuracy of Colposcopic Examination and Pap Smear Cytology As Screening Test In Unhealthy Cervix (original) (raw)
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Role of colposcoy and paps smear in cervical carcinoma screening
2018
Background: Cervical carcinoma is a formidable threat to the health of women and it is prevented with adequate screening. Routine screening of cervical cytology with the Papanicolaou/Pap smear has been deeply ingrained in clinical practice since past century. Cervical cytology screening has contributed to a 50% reduction in the incidence of cervical cancer. Objective of study: To study screening of cervical carcinoma by paps smear and colposcopy. The study constituted 100 women as subjects who attended the Gynaecology OPD as well as ones admitted in gynaecology wards at NIMS hospital Jaipur and fulfilling the inclusion and exclusion criteria. Results: The mean age of patients in this study was 39.05±8.587years and mostly belonging to upper lower socioeconomic status. It was found that early sexual activity had greater risk for development of dysplasia. In this study Mean age at first coitus was 17.13±1.5351. Pap smear had sensitivity of 26.67%, specificity of 100%, and accuracy of 7...
Effectiveness of Pap Smear & Colposcopy, 2017
Pap smear has been the gold standard for cervical cancer screening for the past few decades. Colposcopy has been used as an adjunct in diagnosing pre invasive cervical disease and cervical cancer. This was a retrospective observational study done on patients attending the colposcopy clinic in the Department of Obstetrics & Gynecology, Hospital Sultan Ismail Johor Bahru, a tertiary gynaeoncological referral hospital. The study evaluated all abnormal Pap test referred for colposcopy from 2014 to 2016. The study was done on 163 women who came with an abnormal pap smear or abnormal looking cervix or symptoms. We looked at several key points such as the incidence & demographics of patients with abnormal smears referred for colposcopy, the indications of referral for abnormal pap smears, the correlation between the pap smear & colposcopy results, the correlation between colposcopy finding and histology results & finally the incidence of cervical cancer detected by pap smear and colposcopy. The commonest age group referred for colposcopy was between the ages 40 to 60 years old. The majority of the patients (32 %) who were referred for colposcopy had HSIL. The percentage of pap smear-colposcopy correlation over the 3 years were averaging 50 % to 65 % which is roughly the sensitivity of the pap test. The rate of correlation between colposcopy and final histopathology improved with each year as the training of doctors improved. In 2014, 59 % of the patient’s colposcopy results correlated with the biopsy, while in 2016, 68% of the data correlated. This is fairly similar to other centers which have recorded correlation rates of 60 – 70 %. Cervical cancer is a preventable disorder as there are effective screening and diagnostic tools. A pap smear can detect abnormal cells in the cervix while colposcopy helps in detecting the lesions on the cervix with better precision and helps confirm the diagnosis. From our study, we also found that colposcopy performs better in detecting high grade lesions than low grade lesions. Our study also showed that multiple colposcopic guided biopsies are more specific and accurate than single biopsy alone. As doctors training improved, the rate of correlation and positive predictive value also increased.
Correlation of colposcopic findings with biopsy in cervical cancer screening
International Journal of Clinical Obstetrics and Gynaecology, 2020
Aim: to correlate the colposcopic findings with biopsy in cases of abnormal cervical cytology Materials and Methods: This was a prospective clinical study conducted among 300 women who fulfilled the selection criteria were conducted in the Department of Obstetrics and Gynaecology at Muzaffarnagar Medical College & Mahesh hospital from the November 2017 to November 2019. Patients who had pathological cervical appearance or Pap smear results of ASCUS, AGUS, LSIL or HSIL were referred to colposcopy. Results: Majority (40.0%) women were between 30-39 years of age group. Histopathology confirmed chronic cervicitis in 5 (9.1%) cases, 35 (63.6%) women with CIN I, 12 (21.8%) with CIN II, 3 (5.5%) with CIN III. The colposcopy and histopathology findings correlated in 90.9% cases. Conclusion: study demonstrated correlation between colposcopy and histology. Women with clinical diagnosis of unhealthy cervix should be evaluated by cytology to detect any premalignant or malignant lesions.
Background Cancer cervix develops from the premalignant lesions (CIN) over a period of time which can be diagnosed by screening tests. The Papanicolaou (Pap) smear was the initial screening test for CIN and invasive cervical cancer. However, the simultaneous use of Pap smear and colposcopy has been shown to increase the rate of the cervical cancer detection. This study was done to assess the reliability of colposcopy by correlating the findings of colposcopy with cytology and colposcopic directed biopsy in women with unhealthy cervix. Materials And Methods This was a prospective observational study conducted in 100 women aged between 20 to 65 years with unhealthy cervix. All were subjected to screening by Pap smear, colposcopy and colposcopic guided biopsy and their results were compared and correlated. Final correlation of the Pap smear and colposcopy were based on histopathology results. Results In the present study, the sensitivity of Cervical colposcopy was more than Pap smear (90.3% Vs 67.25%) but its specificity was only 64.9% compared to 97.7% of the Pap smear. This study demonstrated a high correlation between colposcopy and histology of 94.84%. The correlation between Pap smear and colposcopy was 99 %. The correlation between Pap smear and histology was 82%. Conclusion Colposcopy and colposcopic directed biopsy should be included along with Pap smear in screening for early detection of cancer of cervix since the accuracy of detection of cervical abnormalities is higher when they are used complementarily.
Open Journal of Obstetrics and Gynecology, 2018
Objective: This study was conducted to evaluate the role of colposcopy in the screening of cervical cancer at the UTH in Conakry. Material and Methods: We conducted a descriptive study on over a period of 18 months of from the 1 July 2004 to December 31, 2005 in the CHU of Conakry Any women aged from 25 to 65 years old who has agreed to the screening of cervical cancer by colposcopy was included. Statistical tests of sensitivity, specificity, and predictive values positive and negative were computed directly and compare among all participants. Results: During the study period, we included a total of 9339 women. For all precancerous and cancerous lesions, sensitivity and specificity were 93% and 64% respectively. With a positive predictive value of 46% and the negative predictive value of 90%, low and high grade precancerous lesions were found with: a sensitivity of 91%, the specificity of 64%. The positive predictive value of 37%, and the negative predictive value of 91% were estimed. Intra epithelial lesions (LIEBG) low-grade squamous sensitivity was 94%, specificity of 62%, the positive predictive value of 31%, the negative predictive value of 95%. For lesions intra epithelial highgrade squamous (LIEHG), the sensitivity was 85%, 10%, the positive predictive value of 74% specificity, negative predictive value of 95%. Conclusion: Colposcopy is a reference method of detection of precancerous lesions of the cervix to promote cancer.
Role of Colposcopy in the Evaluation of Unhealthy Cervix and Cervical Intraepithelial Neoplasia
Journal of Evidence Based Medicine and Healthcare, 2020
BACKGROUND Invasive cancer of cervix is preventable because it has a long pre-invasive phase, cervical cytology screening is possible, and the treatment of pre-invasive lesions is effective. There are various methods available for screening of cervical precancerous and cancerous lesions like Visual Inspection by Acetic Acid (VIA), Visual inspection by Lugol's Iodine (VILI), conventional pap smear, liquid based cytology, colposcopy and HPV DNA testing. But, negative cytology does not rule out cervical intraepithelial lesions (CIN) completely. In this study we have studied patients with symptoms, abnormal appearing cervix, and patients with abnormal cytology by colposcopy to detect intraepithelial neoplasia of cervix. METHODS In this cross-sectional observational study of 149 subjects, women attending outpatient department of Obstetrics and Gynaecology who were symptomatic for recurrent and persistent vaginal discharge, postcoital bleeding, menstrual abnormalities were examined by per speculum examination and cervical cytology obtained. In indicated patients, colposcopy was done and colposcopic directed biopsy of lesions was taken for evaluation and the results compared. RESULTS Colposcopy showed accurate estimation in 57.89% cases, over estimation in 36.84% cases and under estimation in 5.26% cases. Sensitivity of colposcopy in our study was 98.30%. Specificity of colposcopy in present study was 57.30%. Positive predictive value of colposcopy in our study was found to be 68.75%, negative colposcopy value was 96.66%. Prevalence of CIN in our study group was found to be 39.43%. CONCLUSIONS Colposcopy was found to be useful in understanding the morphology of the cervical lesions, both of the benign and neoplastic and this was very helpful in planning their management. In spite of less specificity and less positive predictive value in our study, a detailed colposcopic evaluation of cervix with a guided biopsy is recommended as an important diagnostic method for the detection of precancerous lesions and early cervical cancer.
Journal of Family Medicine and Primary Care, 2021
Introduction: Back in India, cervical cancer is the second most frequent cancer in women (aged 15-45 years) following breast cancer, accounting for nearly 14% of all female cancer cases. The aim of this study is to yell the findings of pap smear with colposcopy and directed biopsy (if needed) and to evaluate the usefulness of colposcopy in discovering the premalignant and malignant lesions of the cervix. Methods: This is a prospective observational analysis of 150 symptomatic women attending the gynecology OPD of Indira Gandhi Institute of Medical Sciences, Patna, for a period of one year from 2019 to 2020. Assessment of symptomatic women was completed with a pap smear, colposcopy, and biopsy in selected instances. Statistical Analysis Used: MS Excel spreadsheet application, SPSS v23 (IBM Corp.), was used for data analysis. Results: The expression age (years) has been 34.68 ± 8.05. The sensitivity and specificity of pap smear were 91.7% and 45.45%, respectively, whereas the sensitivity and specificity of colposcopy were 83.3% and 72.72%, respectively, in the present study. Conclusions: Pap smear had low specificity as compared to colposcopy. Hence simultaneous use of colposcopy has shown to rise in the rate of carcinoma cervix discovery in symptomatic women.
Asian Pacific journal of cancer prevention: APJCP
Cervical cancer is preventable, although it is common in developing countries and Iran, where there is no defined approach to "atypical squamous cells of undetermined significance" (ASCUS) on Pap smears. This study determined the value of colposcopy in the early diagnosis of cervix cancer in females with ASCUS. This accuracy study examined 213 ASCUS cases referred from different cities from 2007 to 2009. All patients underwent a repeated conventional Pap smear, colposcopy, endocervical curettage, and a cervical biopsy, considered the gold-standard diagnostic test. There was no significant relationship between age, age of first intercourse, smoking, or number of children and a positive cervical biopsy. The sensitivity and specificity of a repeat Pap smear for ASCUS were 15 and 93%, respectively, while the respective values for diagnosing cervical cancer with colposcopy were 80 and 80%. Endocervical curettage had 64% sensitivity and 100% specificity for diagnosing cervical c...
Diagnostic efficacy of pairing cytology and colposcopy in screening of cervical neoplasia
Innovative Publication, 2016
Introduction: Cancer of uterine cervix is the most common genital tract malignancy. Pap smear though widely used screening test for cervical cancer has the disadvantage of low sensitivity. Colposcopy has higher sensitivity compared to Pap smear. Concurrent screening with Pap smear and colposcopy can overcome this problem. Aim: The aim of the study was correlation of Pap smear and colposcopic finding with directed biopsy in detection of cervical neoplasm. Methods: During the study period in 57 symptomatic patient's simultaneous Pap smear, colposcopic examination, followed by directed biopsy was performed. Data was recorded and analyzed. Results: In correlation between cytology and biopsy, sensitivity of cytology was 82.3%, specificity 96.9% and accuracy of 92%. In correlation between colposcopy and biopsy, sensitivity of colposcopy was 94.1%, specificity 87.8% and accuracy of 90%. Conclusion: High sensitivity in colposcopy as compared to cytology and high specificity in cytology as compared to colposcopy emphasizes the need for pairing these methods to achieve better results.