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Rema, Prabhakaran Nair, Aleyamma Mathew, and Shaji Thomas. "Performance of colposcopic scoring by modified International Federation of Cervical Pathology and Colposcopy terminology for diagnosing cervical intraepithelial neoplasia in a low-resource setting." South Asian Journal of Cancer 08, no. 04 (October 2019): 218–20. http://dx.doi.org/10.4103/sajc.sajc_302_18.
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Abstract Introduction: Colposcopy is a tool to evaluate women with cervical pre-cancer and cancer. To interpret the colposcopic findings, various scoring systems are used but with inter observer variations. To improve the quality of colposcopy, International Federation of Cervical Pathology and Colposcopy (IFCPC) has introduced a colposcopic nomenclature in 2011. Colposcopic scoring helps to select patients who need treatment for cervical intraepithelial neoplasia. Aim of the Study: The study aimed to evaluate the agreement between colposcopic diagnosis with the modified IFCPC terminology and cervical pathology in patients with abnormal screening tests and to assess the utility of this colposcopic scoring system in low resource settings. Methodology: Patients with abnormal screening tests who underwent colposcopic assessment in the department of Gynaecological oncology were included in the study. Colposcopic scoring was done by the modified IFCPC nomenclature. The results were compared with cytology and the final histopathology. Results: 56 patients were included in the study. The colposcopic scoring when compared to histopathology showed agreement in 65.7% which indicated the agreement was substantial and was statistically significant (P = 0.0001). With cytology the colposcopic score showed agreement in 35.6% indicating a fair agreement and this was also statistically significant (P = 0.001). Conclusion: Colposcopic scoring by modified IFCPC 2011 criteria showed substantial agreement with cervical histopathology. Compared to traditional methods, 2011 international terminology of colposcopy could improve colposcopic accuracy.
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Verma, Indu, Pratibha Pundhir, Tejinder Kaur, Veena Jain, and Dinesh Sood. "Evaluation of Reid’s Combined Colposcopic Index as a predictor of cervical intraepithelial lesion." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 9 (August 27, 2018): 3724. http://dx.doi.org/10.18203/2320-1770.ijrcog20183784.
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Background: Carcinoma cervix is the commonest cancer among women worldwide and in India it accounts for 80% of all genital cancers. Screening methods include cervical cytology, human papilloma virus testing and colposcopy. Objective of present study was to evaluate suspicious cervix colposcopically using Reids Colposcopic Index (RCI) and to correlate RCI with histopathological findings.Methods: This was a prospective cross sectional study done on 125 women with clinical diagnosis of suspicious cervix. Colposcopy was performed and grading of the disease was done according to RCI. Positive cases were subjected to cervical biopsy and endocervical curettage was performed in unsatisfactory colposcopy.Results: Colposcopy was done on 125 women with suspicious cervix. Out of 125, sixty two showed abnormal colposcopic findings which were graded according to RCI into Low grade disease predicting histological diagnosis of CIN1 in 47, Intermediate grade disease predicting histological diagnosis of CIN1/2 in 11 and High grade disease predicting histological diagnosis of CIN2/3 in 4 women. Colposcopy of one women suggested invasive carcinoma and was confirmed on histopathology to be microinvasive squamous cell carcinoma. Six women with unsatisfactory colposcopy showed benign histopathology. Sensitivity, specificity, predictive value and false negative rate of colposcopy for invasive disease was 50%, 100%, 100% and 1.60% respectively with 98.40% diagnostic accuracy. Colposcopic diagnosis of invasive disease and histopathology report showed 100% correlation.Conclusions: Correlation between RCI and histopathology was good. Predictive accuracy of colposcopy increased with increasing severity of disease.
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Sinha, Mridu, Jai Kishan Goel, Shashi Bala Arya, Jayanti Kar, Bahar Kohli, and Isha Tapasvi. "Comparison of Pap Smear and Colposcopy in Detection of Premalignant Lesions of Cervix." Journal of SAFOMS 2, no. 1 (2014): 5–8. http://dx.doi.org/10.5005/jp-journals-10032-1023.
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ABSTRACT Objective Comparison of papanicolaou (pap) smear and colposcopy in detection of premalignant lesions of cervix. Materials and methods A prospective clinical study was conducted in a tertiary care referral institute in 100 symptomatic, sexually active women of 20 to 60 years. All women were subjected to pap smear, colposcopy and cervical biopsy to confirm the diagnosis. Results Out of 49 positive on pap smear, 24 were true positives and 25 were false positives. Out of 51 negative pap smear findings, 45 were true negatives and 6 were false negatives. Thirty percent women had positive histopathology and colposcopic findings. Forty percent women had normal colposcopy with negative histopathology whereas 30% had positive colposcopic findings but negative histopathology. Nineteen percent of women with negative cytology were positive on colposcopy and histopathology. Conclusion Pap smear had a sensitivity of 80% and a specificity of 64.29% with positive predictive value of 48.98% and negative predictive value of 88.24% while sensitivity and specificity of colposcopy were 100 and 57.14% respectively and positive predictive value and negative predictive value of colposcopy were found to be 50 and 100% respectively. How to cite this article Kohli B, Arya SB, Goel JK, Sinha M, Kar J, Tapasvi I. Comparison of Pap Smear and Colposcopy in Detection of Premalignant Lesions of Cervix. J South Asian Feder Menopause Soc 2014;2(1):5-8.
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Omeragić, Feđa, Azur Tulumović, Ermina Iljazovic, Amela Adzajlic, Alija Suko, Larisa Mešić-Đogic, and Vladimir Perendija. "Use of colposcopy for detection of squamous intraepithelial lesions." Journal of Health Sciences 4, no. 2 (August 29, 2014): 72–76. http://dx.doi.org/10.17532/jhsci.2014.162.
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Introduction Pap smear, the main tool of cervical cancer screening is not always available, but some patients are in urgent need for proper diagnostic. Aim of this article was to investigate accuracy of colposcopy for detection of squamous intraepithelial lesions of low or high grade (LGSIL, HGSIL) and to promote colposcopy as useful tool for detection of patients in need for immediate further diagnostics. Methods Prospective multicentric study performed in B&H in 2012 -2013 included 87 patients with colposcopic images related to squamous intraepithelial lesion (SIL) who formed experimental group: 56 patients with colposcopic images related to LGSIL and 31 patients related to HGSIL. Control group included 50 patients without colposcopic abnormalities. To test accuracy of colposcopy, PAP smear and histology were used. For statistical analysis χ2 was used.Results 94.5% patients in experimental group had abnormal PAP test: 64.3% correlated to LGSIL (χ2= 60.48 P < 0.0001), while 64.5% correlated to HGSIL (χ2 = 54.23 P<0.0001) Odds Ratio = 490; 95% CI = 42.024 to 5713.304). HGSIL was confirmed in 27 (87%) cases by histology (CIN II /CIN III). There were no statistically significant differences between colposcopic finding and histology results (Yates-corrected χ2 = 0.33 P = .5637)Conclusions This study showed high level of correlation between colposcopy and PAP results (63-64%) and to histology for HGSIL (87%). In absence of PAP test colposcopy could be used to select patients in need for biopsy.
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Desai, BR, PR Malur, Dalal Anita, Durdi Geeta, Sherigar Bhavana, and Gupta Pallav. "Sequential Screening with Cytology and Colposcopy in Detection of Cervical Neoplasia." Journal of South Asian Federation of Obstetrics and Gynaecology 1, no. 3 (2009): 45–48. http://dx.doi.org/10.5005/jp-journals-10006-1009.
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ABSTRACT Background Pap smear is the most commonly used screening test for cervical cancer, however it has disadvantage of having low sensitivity. Colposcopy has higher sensitivity as compared to Pap smear but low specificity. Sequential screening with both Pap smear and colposcopy can overcome these problems. Aim The study was aimed to find out the diagnostic efficacy of both Pap smear and colposcopy. It was also intended to find out the advantages of sequential use of Pap smear and colposcopy in screening for cervical cancer. Design It was a cross-sectional study conducted in colposcopy clinic of KLE's Dr. Prabhakar Kore Hospital and MRC, Belgaum from November 2006 to September 2008. Material and methods A total of 190 patients with complaints of postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, persistent vaginal discharge or those found to have an unhealthy cervix on per speculum examination were included in the study. In all the 190 cases Pap smear, colposcopic evaluation and colposcopic directed biopsy were performed. Statistical analysis Sensitivity, specificity, positive predictive value, negative predictive value of both Pap smear and colposcopy were calculated with histopathology as a gold standard, keeping LSIL as a disease threshold for test positivity. Results Pap smear was positive in 14.21% (27/190) cases, colposcopy was positive in 37.89% (72/190) cases. Biopsy confirmed LSIL and higher lesions in 31.57% cases. The sensitivity, specificity, positive predictive value and negative predictive value of Pap smear were 41.66%, 96.92%, 86.21% and 78.26% respectively and 80%, 81.54%, 66.66% and 89.83% respectively for colposcopy. Combined colposcopy and Pap smear could accurately diagnose 53/60 biopsy confirmed cases of LSIL and higher lesions with an accuracy of 88.33%. Conclusion Sequential use of Pap smear and colposcopy in screening for cervical cancer increases the accuracy of the test.
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Gyawali, P., S. R. KC, and S. Ghimire. "Role of Colposcopy in Detection of Dysplastic Cervical Lesion as a Screening Tool." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 33s. http://dx.doi.org/10.1200/jgo.18.51300.
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Background: Age standardized cervical cancer incidence rate in Nepal is 19.2/100,000 woman, compared with 14.0 worldwide. Similarly, mortality rate is 12.0 women which is significant in comparison with 6.8 worldwide. Cervical intraepithelial neoplasm is a precursor lesion, having high transformation rate into the cervical carcinoma. Data clearly indicates that CIN 2 and 3 has more progression into cervical carcinoma. Despite the fact that Papanicolaou test has remained an important tool in the screening for cervical cancer and has contributed in significant decrease in cervical cancer, sensitivity and specificity of conventional Papanicolaou test is quite low. Colposcopy is visual inspection of cervix under magnification. Study revealed that the positive predictive rate of the colposcopic impression is better as the cervical lesion is more severe. Aim: To find out the significance of colposcopy in the detection of dysplastic cervical lesions and possible use of this method as a screening tool. Methods: This is an observational study done at Cancer Care Foundation, Nepal done from a period of January 2015 to February 2018. Permission was obtained from ethical committee and written consent was obtained from the patients. All the patients suspected having dysplastic or invasive lesions or in whom colposcopy-guided biopsy was performed; were included in the study. Relevant data were collected which included age, colposcopic diagnosis, histopathological diagnosis. Data were entered into Microsoft Excel and statistical analysis was done from statistical package SPSS 21. Results: 6109 females were screened through colposcopy. Out of these 900 patients underwent colposcopy-guided biopsy for being suspected of dysplastic lesions or inflammatory lesions. Mean age of females was 40.65 years. With colposcopy, 407 (45.2%) were suspected to have low grade lesion, followed by 401 (44.6%) high grade lesion and 15 (1.7%) carcinoma. Nonneoplastic lesions were suspected in 77 (8.6%) females. In the histopathological examination low grade dysplasia was observed in 403 (44.8%) followed by 250 (27.8%) high grade dysplasia and 8 (0.9%) carcinoma in-situ or invasive carcinoma. Similarly, 239 (26.6%) patients had nonneoplastic lesions. In colposcopy, high grade lesions were suspected more frequently in females of 41-50 years age group than in 31-40 years age group ( P < 0.01). Correlation between increasing age and dysplastic lesions were also observed ( P < 0.05). There was significant correlation between colposcopic diagnosis and histopathological diagnosis with a P value < 0.01. The sensitivity of colposcopy to diagnose dysplastic lesions were high 96.44% with positive predictive value of 62.65%. The specificity of colposcopy to diagnose various grades of dysplastic lesions is 34.98%. Conclusion: Colposcopy is highly sensitive method of screening dysplastic cervical lesions and should be used more frequently as a screening purpose.
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Katz, Leticia Maria Correia, Alex Sandro Rolland Souza, Juliana Melo de Moraes Guerra, and Melania Maria Ramos Amorim. "Is it necessary to repeat cervical cytology at the tie of a colposcopy?" Revista Brasileira de Saúde Materno Infantil 12, no. 3 (September 2012): 319–26. http://dx.doi.org/10.1590/s1519-38292012000300011.
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OBJECTIVES: to evaluate whether repeating Papanicolaou smear testing at the time of colposcopy improves agreement between cytology and histopathology in the diagnosis of cervical cancer. METHODS: this cross-sectional study included 397 women referred for colposcopic evaluation following an abnormal cervical smear test. The cytology was repeated at the time of the colposcopy using a conventional medium. The two cytology tests were compared with each other and with the histopathological findings obtained by colposcopy-directed biopsy. The 2001 Bethesda system and the WHO 1994 classification were used for reporting cytology and histology results. The kappa coefficient was used to determine the agreement between methods. RESULTS: the comparison between the initial cytology findings and cytology performed at the time of colposcopy revealed a kappa of 0.297 (95%CI: 0.235-0.359), indicating a fair degree of agreement. When the results of the initial cytology were compared with histopathology, a kappa of 0.261, considered to represent a fair degree of agreement, was obtained (95%CI: 0.181-0.340). A kappa of 0.408, considered to represent moderate agreement, was found when the second cytology findings were compared with the histopathology (95%CI: 0.332-0.485). CONCLUSIONS: the agreement between cytology and histology improved when cytology was repeated at the time of colposcopy, following an initial abnormal test.
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Newman, Haley, Jilin Hu, Xiao Li, Jing He, Leslie Bradford, Songmei Shan, Xiaomei Wu, et al. "Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China." International Journal of Gynecologic Cancer 29, no. 1 (January 2019): 23–27. http://dx.doi.org/10.1136/ijgc-2018-000006.
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ObjectiveTo evaluate the use of a portable, rechargeable colposcope combined with human papillomavirus (HPV) testing, as compared with HPV testing alone, for screening of cervical cancer and pre-cancerous lesions.MethodsThis was a cross-sectional study among 488 women in Baoshan County, Yunnan. The women underwent HPV testing followed by Gynocular portable colposcopy with visual inspection with acetic acid. Obvious lesions were biopsied. If portable colposcopy testing was negative but HPV testing was positive, the women underwent follow-up testing with thin-prep cytology and traditional colposcopy. Cervical biopsies were performed for any abnormalities. Histopathology was followed up with diagnosis and treatment.ResultsAmong 488 women screened with portable colposcopy, 24 women underwent biopsy based on positive colposcopy screening. Of these 24 women, three were HPV positive and 21 were HPV negative. Five women had cervical intra-epithelial neoplasia (CIN) I and one had advanced cervical cancer. Forty-six women tested positive for HPV. Three of these women had screened positive on preliminary colposcopy, with one positive for CIN III/squamous cell carcinoma and one woman with CIN I. Forty-three women underwent follow-up testing with thin-prep cytology. Two women had atypical squamous cells of undetermined significance and five had low-grade squamous intra-epithelial lesions and were biopsied; three women had CIN I, one had CIN II and one had CIN III. HPV testing and portable colposcopy was more sensitive but slightly less specific than portable colposcopy or HPV testing alone.ConclusionWhile HPV testing has high sensitivity and specificity for the detection of pre-cancerous and cancerous lesions and portable colposcopy has lower specificity, both methods of detection have low positive predictive value and high negative predictive value. In tandem, HPV testing and portable colposcopy had higher sensitivity for detection among women who underwent biopsies. In clinical practice, portable colposcopy was an effective, easy and affordable tool to transport to villages where cytology is not currently feasible.
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Hilal, Ziad, Clemens Tempfer, and Günther Rezniczek. "Treatment of Cervical Dysplasia by Clinicians Who Perform Colposcopy in German-speaking Countries – a Questionnaire-based Study." Geburtshilfe und Frauenheilkunde 79, no. 02 (February 2019): 189–97. http://dx.doi.org/10.1055/a-0828-7831.
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Abstract Introduction In connection with the reorganisation of cervical carcinoma screening, the importance of colposcopy as an integral part of the planned series of clarification testing will greatly increase. Quality standards for performing the colposcopic examination should therefore be defined in detail. A precondition for this is surveying the current standard in clinical practice. The objective of this study was to evaluate the current practice of colposcopy and conisation in Germany by means of a questionnaire aimed at gynaecologists who perform colposcopies in order to document the actual therapeutic standard of treatment of cervical dysplasia. Materials and Methods Gynaecologists were invited via e-mail or during events to participate in a web-based survey. The questionnaire contained 38 questions on management before, during and after the examination as well as questions on the technical implementation of colposcopy and conisation. Results From February 2018 to April 2018, 961 e-mails were sent. A response was received in 197 cases (response rate 20.5%). Responses were received for another 40 questionnaires during events (response rate approx. 80%). After taking the inclusion criteria into account, 160 questionnaires were evaluated. The majority of those surveyed take an average of 2 cervical biopsies (67.3%) and nearly all of those surveyed (94.5%) do not use any local anaesthetic. As a standard method for removing cervical precancerous cells, most of the physicians surveyed perform a loop excision with the electrosurgical loop (91.2%) under colposcopic visualisation (61.2%) under general anaesthesia (92.5%). Postoperative bleeding prophylaxis by means of tamponade is performed only in 27.6% of all cases. Conclusion A differential colposcopy with two colposcopically targeted biopsies and treatment with the electrosurgical loop are the methods most frequently used by clinicians who perform colposcopy in Germany. A uniform procedure should be defined in detail within the scope of directives or guidelines.
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Sharma, Akanksha, Saritha Shamsunder, Niti Khunger, Geetika Khanna, and Vijay Zutshi. "CHRONIC VULVAL SYMPTOMS: COMPARISON OF VARIOUS DIAGNOSTIC METHODS." International Journal of Advanced Research 9, no. 02 (February 28, 2021): 310–14. http://dx.doi.org/10.21474/ijar01/12448.
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The aim of our study was to compare the various diagnostic modalities for evaluation of chronic vulval symptoms. We studied 100 women presenting with chronic vulval symptoms who underwent examination of vulva with low magnification, scrape cytology, colposcopy & directed biopsy. The overall sensitivity and specificity for detecting vulvar lesions was 29.87% and 100% with low magnification 58.44% and 13.04% with cytology 77.92 % and 17.39 % with colposcopy. We concluded that clinical examination with or without magnification can detect most of the neoplastic lesions. Colposcopy and cytology have high negative predictive value and provide reassurance in absence of disease.
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Begum, Ferdousi, Setara B. Kasem, Shaikh A. Razzaque, Raisa Adiba, and Selma Anika. "Role of Colposcopy in the Evaluation of Visual Inspection of Cervix with Acetic Acid-positive Cases of Unhealthy Cervix." Journal of SAFOMS 5, no. 2 (2017): 102–6. http://dx.doi.org/10.5005/jp-journals-10032-1116.
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ABSTRACT Introduction Cervical cancer is the second most common cancer in women worldwide, and it is the principal cancer of women in most developing countries, where 80% of cases occur. This disease is preventable by screening and treatment of preinvasive condition. All sexually active women are at risk of acquiring a human papillomavirus (HPV) infection that may lead to cervical cancer in the future. Cervical cancer is a preventable disease as the different screening, diagnostic, and therapeutic procedures are effective. The screening procedures are visual inspection of cervix with acetic acid (VIA), Pap smear, colposcopy, and HPV deoxyribonucleic acid test. Among them, colposcopy is effective in screening, taking colposcopy-directed biopsy as well as treatment of cervical intraepithelial neoplasia (CIN), such as cold coagulation, cryotherapy, and loop electro-surgical excision procedure. Hence, there is an obvious need to subject the women with VIA-positive report to colposcopy and directed biopsy. This study is done to evaluate the role of colposcopy in evaluation of VIA-positive cases. Objective Colposcopic evaluation of VIA-positive cases and detection of precancerous lesion of cervix for early management. Materials and methods This was a cross-sectional study done among married female patient aged 22 to 65 years, who had VIA-positive report, and attending the colposcopy clinic in the Department of Obstetrics and Gynecology of Sir Salimullah Medical College and Mitford Hospital from January 2014 to December 2016. Colposcopy-directed punch biopsy was taken from the abnormal colposcopic appearance and specimen sent for histopathological examination. Results Out of 97 cases, all had VIA-positive acetowhite areas. But colposcopy revealed that 76.29% had CIN and invasive lesions, while 23.71% had either normal or inflammatory lesions. Colposcopy-directed punch biopsy revealed that 59.79% cases had positive lesions like CIN or invasive carcinoma and 40.21% had neither CIN nor invasive lesions. Among positive lesions, about 34.02% had CIN I, 3.09% had CIN II, 0% had CIN III, and 22.68% had invasive carcinoma. In this study, sensitivity and specificity of colposcopy examination were found 94.83 and 51.28% respectively. Conclusion Cervical cancer presents as major cause of morbidity and mortality, especially in developing countries like Bangladesh. In developing countries, the various screening programs are implemented for its early detection and treatment. It is evident that colposcopy plays a very important role in early diagnosis and treatment of preinvasive and early invasive carcinoma of cervix. So wide use of colposcopy in screening program of Bangladesh can reduce many young women's morbidity and mortality. How to cite this article Kasem SB, Razzaque SA, Adiba R, Anika S, Begum F. Role of Colposcopy in the Evaluation of Visual Inspection of Cervix with Acetic Acid-positive Cases of Unhealthy Cervix. J South Asian Feder Menopause Soc 2017;5(2):102-106.
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Wentzensen, Nicolas, Joan L. Walker, Michael A. Gold, Katie M. Smith, Rosemary E. Zuna, Cara Mathews, S. Terence Dunn, et al. "Multiple Biopsies and Detection of Cervical Cancer Precursors at Colposcopy." Journal of Clinical Oncology 33, no. 1 (January 1, 2015): 83–89. http://dx.doi.org/10.1200/jco.2014.55.9948.
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Purpose Women with abnormal cervical cancer screening results are referred to colposcopy and biopsy for diagnosis of cervical cancer precursors (high-grade squamous intraepithelial lesions [HSILs]). Colposcopy with a single biopsy can miss identification of HSILs. No systematic study has quantified the improved detection of HSIL by taking multiple lesion-directed biopsies. Methods The Biopsy Study was an observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results. Up to four directed biopsies were taken from distinct acetowhite lesions and ranked by colposcopic impression. A nondirected biopsy of a normal-appearing area was added if fewer than four directed biopsies were taken. HSIL identified by any biopsy was the reference standard of disease used to evaluate the incremental yield and sensitivity of multiple biopsies. Results In the overall population, sensitivities for detecting HSIL increased from 60.6% (95% CI, 54.8% to 66.6%) from a single biopsy to 85.6% (95% CI, 80.3% to 90.2%) after two biopsies and to 95.6% (95% CI, 91.3% to 99.2%) after three biopsies. A significant increase in sensitivity of multiple biopsies was observed in all subgroups. The highest increase in yield of HSIL was observed for women with a high-grade colposcopic impression, HSIL cytology, and human papillomavirus (HPV) type 16 positivity. Only 2% of all HSILs diagnosed in the participants were detected by biopsies of normal-appearing transformation zone. Conclusion Collection of additional lesion-directed biopsies during colposcopy increased detection of histologic HSIL, regardless of patient characteristics. Taking additional biopsies when multiple lesions are present should become the standard practice of colposcopic biopsy.
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Kaptilny, Vitaly A., and A. V. Belova. "METHODS OF PERFORMING A PLAIN AND ADVANCED COLPOSCOPY." V.F.Snegirev Archives of Obstetrics and Gynecology 5, no. 2 (June 15, 2018): 106–12. http://dx.doi.org/10.18821/2313-8726-2018-5-2-106-112.
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This review is devoted to the technique of the performing colposcopy in the modern obstetrical and gynecological practice. Special attention is paid to the value of this method, the diagnostic significance of the results of the survey. The preparation for the study, the purpose, and methodology of its implementation are considered. The presented photographs illustrate in detail all the stages of the course of colposcopy.
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Lerman, C., P. Hanjani, C. Caputo, S. Miller, E. Delmoor, S. Nolte, and P. Engstrom. "Telephone counseling improves adherence to colposcopy among lower-income minority women." Journal of Clinical Oncology 10, no. 2 (February 1992): 330–33. http://dx.doi.org/10.1200/jco.1992.10.2.330.
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PURPOSE A randomized trial was conducted to evaluate the impact of a telephone counseling intervention to improve patient adherence to colposcopic examination for suspected cervical intraepithelial neoplasia (CIN). METHODS Subjects were lower-income, minority women who missed a scheduled initial appointment for colposcopy at an urban medical clinic. Patients were randomly assigned to either a control condition (n = 42) or a telephone counseling condition (n = 48). The 15-minute, structured telephone counseling intervention protocol addressed educational, psychosocial, and practical barriers to colposcopy adherence. RESULTS The most common patient-reported barriers to colposcopy adherence included a lack of understanding of the purpose of colposcopy (50%), worry about or fear of cancer (25%), and forgetting (23%). Telephone counseling was found to be highly effective in addressing these barriers and improving adherence to diagnostic follow-up and treatment. Of patients in the control condition, 43% complied with a rescheduled colposcopy appointment, compared with 67% in the telephone counseling condition. Logistic regression analysis indicated that the effect of telephone counseling was independent of sociodemographic confounder variables (odds ratio = 2.6; P less than .003). Additionally, 74% of patients who received the initial telephone counseling adhered to recommended treatment, compared with 53% of patients in the control condition. CONCLUSION Brief, structured telephone contact may be a cost-effective mechanism for improving adherence to diagnostic follow-up and treatment for a variety of cancer screening tests.
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Cantor, S. B., M. Cárdenas-Turanzas, M. Follen, and D. D. Cox. "The accuracy of colposcopy in diagnostic and screening settings." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 1545. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.1545.
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1545 Background: We sought to determine the accuracy of colposcopy to diagnose cervical precancer in screening and diagnostic settings. Methods: As part of a larger clinical trial, 1850 patients were recruited into a diagnostic group or a screening group depending on their history of abnormal Papanicolaou smear results. For all patients, colposcopic examination was performed and biopsies were obtained from abnormal and normal colposcopic sites. The gold standard of test result accuracy was the histologic report of biopsies. Results: The diagnostic group had a 29.0% prevalence of high-grade squamous intraepithelial lesions (HGSIL) or cancer, and the screening group had a 2.2% prevalence of HGSIL or cancer. Using a disease threshold of HGSIL or worse, the diagnostic group had a sensitivity of 71.4% and a specificity of 81.3%, and the screening group had a sensitivity of 19.1% and a specificity of 96.1%. The areas under the receiver operating characteristic (ROC) curves for the diagnostic and screening groups at the same disease threshold were 0.854 and 0.511, respectively. Conclusions: We demonstrated that colposcopy performs well in the diagnostic setting and poorly in the screening setting. Colposcopy should not be used for the screening of cervical intraepithelial neoplasia. No significant financial relationships to disclose.
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Karya, Urmila, Azme Zehra, and Anupam Rani. "Evaluation of swede score and reid score to improve the predictive value of colposcopy and its correlation with histology." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 5 (April 28, 2020): 2059. http://dx.doi.org/10.18203/2320-1770.ijrcog20201805.
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Background: Cervical carcinoma is the second most common malignancy amongst women in India. It is regarded as a public health problem and a priority in cancer control programmes by the WHO. Colposcopy has proven to be very useful in identifying and guiding the biopsy of dysplastic lesion. To minimize inter-observer variation, colposcopic scoring system has been introduced.Methods: A prospective cross- sectional study including 250 women in whom the prevalence of different grades CIN was done. Co-relation of Pap (cytology) with colposcopy scoring system viz. Reid’s and Swede scores, has been made in this study. The two screening methods were compared and their statistical association with histological findings were analyzed.Results: Per speculum examination performed in 250 sexually active women with suspicious looking cervix, belonging to 25-60 years of age, with most common presenting complaints of pain abdomen (38.8%) followed by leucorrhoea, irregular cycles and Post coital bleed. Unhealthy cervix (49.2%) and persistent discharge (28%) were the most common indications for colposcopy. An assessment of both SWEDE score and Reid score as a function of histological findings was done, while Swede score of >5 showed slightly more sensitivity (100%) for diagnosing CIN1+ lesions, Reids score of >5 was more specific (100%) with a higher positive predictive value (100%) for diagnosing CIN 1, 2, 3 and invasive cervical carcinoma. There was a marked positive association between Reid score and SWEDE score.Conclusions: The colposcopic scoring systems and histopathology showed significant compliance. Predictive accuracy of colposcopy increased with increasing severity of disease.
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Amatullah, Mehriban, and Shirin Akter Begum. "Evaluation of coloscopic and Pap’s smear findings among visual inspection with acetic acid cases in detection of precancerous lesion of cervix against histopathology." Bangladesh Medical Research Council Bulletin 45, no. 2 (August 7, 2019): 103–7. http://dx.doi.org/10.3329/bmrcb.v45i2.42539.
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Background: Cervical cancer is the commonest cancer in women in developing countries. Visual inspection with acetic acid (VIA) is much popular method as primary screening modalities in low resource setting.Whereas Pap smear is well recognized and popular in developed countries. Colposcopy is recognized as the best method for detection of cervical cancer and cervical intraepithelial neoplasia (CIN) as secondary screening. The present study was intended to compare the accuracy of Pap smear and colposcopy in the detection of pre-invasive cervical lesion in VIA positive cases.
Methods: This cross sectional study was carried out in the Colposcopic Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka over a period of 1 year from August 2015. All consecutive VIA positive cases were included the study.
Results: Mean age of the VIA positive women was 36.9 years with peak age group being 31-40 years (44.0%). Nearly three-quarters of the women (74.0%) were in their 3" and 4 decades of life. Among VIA positive women, 35.0% were Pap positive and 55.0% were colposcopically positive and 41.0% were histopathologically positive. Pap smear had low sensitivity (53.7%) and high specificity (78.0%). Using Pap smear nearly half (46.3%) of the precancerous lesion were escaped. Whereas colposcopy findings, revealed high sensitivity (90.2%) and specificity (69.5%). Both Pap and colposcopy was judged against histopathological diagnosis. Over 40.0% of the VIA positive women were diagnosed as CIN confirmed by histopathology. Strength of agreement test using Kappa statistics revealed a moderate agreement between Pap smear test and colposcopy (49.5%).
Conclusion: The study concluded that colposcopy has a high sensitivity, optimum specificity and moderate agreement against histopathology in relation to Pap smear. Pap smear has very little role whereas colposcopy has significant role for diagnosis of CIN. So, it would be adopted and encouraged to do the colposcopy where it is possible.
Bangladesh Med Res Counc Bull 2019; 45: 103-107
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Kasem, Setara Binte, Shaikh Abdur Razzaque, Raisa Adiba, Selma Anika, and Mala Banik. "Colposcopic Evaluation of Visual Inspection with Acetic Acid Positive Cases of Unhealthy Cervix." Journal of Bangladesh College of Physicians and Surgeons 37, no. 2 (March 13, 2019): 60–65. http://dx.doi.org/10.3329/jbcps.v37i2.40561.
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Cervical cancer is the commonest form of cancer in women in virtually all developing countries1. It is the third most common cancer among women worldwide2. Almost 80% of cervical cancer occurs in developing countries. In developed nations, the figure for invasive cervical cancer are much lower due to adaptation of different screening tests1. All sexually active women are at risk of acquiring a Human Papilloma Virus (HPV) infection which may lead to cervical cancer in the future3. Cervical cancer is a preventable disease as the different screening, diagnostic and therapeutic procedures are effective. The screening procedures are VIA (Visual inspection of cervix with acetic acid), Pap’s smear and HPV DNA test. Colposcopy is the triage in screening, taking colpospoy directed biopsy as well as treatment of CIN such as cold coagulation, cryotherapy, and LEEP (Loop electro-surgical excision procedure)4. Objective: To study the role of Colposcopy in the evaluation VIA positive cases of unhealthy cervix, to localize the leisons to obtain the biopsies from the selected areas and detection of precancerous lesion of cervix for early management. Meterials and Methods: This was a prospective observational study done among 306 married women aged 18-65 years who had clinically unhealthy cervix attending the VIA and colposcopy clinic in Department of Obstetrics and Gynaecology of Sir Salimullah Medical College and Mitford Hospital from January 2015 to December 2016. All the patients were subjected to VIA test. Colposcopic evaluation done in VIA positive cases and the findings were noted. Colposcopy directed biopsy was taken from colposcopically suspected areas. Results: Out of 306 cases, 63 women had positive VIA tests and 233 women had negative VIA tests. Colposcopic evaluation were undertaken among 63 VIA positive cases. Colposcopy directed punch biopsy revealed that 28 (60.32%) cases had positive lesions like CIN or invasive carcinoma and 25 (39.68%) had neither CIN or invasive lesions . Among positive leisons about 30.16% had CINI, 1.59 % had CIN II, 0% had CIN III and 28.57% had invasive carcinoma. In this study sensitivity and specificity of colposcopy examination of VIA positive cases were found 94.74% and 56% respectively. Conclusion: It is evident that colposcopy plays a very important role in the evaluation of VIA positive cases of unhealthy cervix. So that early diagnosis and treatment of preinvasive and early invasive carcinoma of cervixis is possible. So wide use of colposcopy in screening program of Bangladesh speciallly in the VIA positive cases can reduce the many young women’s morbidity and mortality.
J Bangladesh Coll Phys Surg 2019; 37(2): 60-65
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Shen, R. N., D. A. Hicks, and M. E. Cruickshank. "Colposcopy services provided by Genito-Urinary Medicine Clinics in the United Kingdom-British Society for Colposcopy and Cervical Pathology/National Co-ordinating Network Survey, 1993." International Journal of STD & AIDS 7, no. 2 (April 1, 1996): 98–101. http://dx.doi.org/10.1258/0956462961917456.
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Postal questionnaires were circulated to all Genito-Urinary Medicine (GUM) clinics in the UK (in parallel with questionnaires circulated to gynaecologists) on behalf of British Society for Colposcopy and Cervical Pathology (BSCCP) and National Co-ordinating Network (NCN) to audit colposcopy services. Information was sought on colposcopy workload, referral criteria, treatment method and followup, waiting times, staffing and training. A similar but less comprehensive survey of colposcopy services in GUM was undertaken in 1990 enabling direct comparison of some but not all aspects of the service in the last 3 to 4 years 1. One hundred and forty-two GUM Clinics replied. Of those who replied, 70 (49.3%) clinics provided a colposcopy service; an increase from 60 to 70 clinics since 1990. However, only 66 clinics provided detailed inform ation for analysis. Forty-six out of 66 (69.7%) clinics performed treatment for some or all of their patients and the most frequent methods of treatment used were loop excision and cold coagulation. One hundred and seventy-two (range 8-1982) patients were seen per annum with a m ean of 7 (range 1- 68) colposcopy sessions per month. Sixty-four per cent of these sessions were undertaken by consultants, 14% by training grades and the rest by Clinical Assistants and Associate Specialists. Fifty-three per cent of all patients with abnormal smears were colposcoped within 2 weeks and the maximum waiting period was less than 8 weeks for all severe dyskaryosis/malignant cells cytology reports; 1.6% of clinics admitted to having cases of invasive cervical cancer following previous treatment of cervical intraepithelial neoplasia (CIN) and 96% of clinics had a protocol in place for defaulters. The default rate was 12% both for new and follow-up patients. Thirty out of 70 (43%) clinics were com puterized and 50/66 (75.8%) of clinics collected accurate statistics.
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Michail, Georgios, Georgios Androutsopoulos, Panagiotis Panas, Georgios Valasoulis, Ifigenia Papadimitriou, Konstantinos Poulas, and Georgios Adonakis. "Effects of Orally Administered Preliminary Analgesic Therapy in Diagnostic Colposcopy Patients: A Prospective Questionnaire Study." Open Medicine Journal 8, no. 1 (February 15, 2021): 1–7. http://dx.doi.org/10.2174/1874220302108010001.
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Background: Colposcopy has a key role in the diagnostic work-up and management of abnormal cervical cytology, but it might generate negative feelings of mainly anxiety and pain to the patients undergoing such examination. These feelings are interrelated, with the anxiety fueling the painful sensations. The aim of our study was to investigate the effects of preliminary administration in terms of pain and anxiety relief that the preliminary administration of paracetamol would have on patients undergoing diagnostic colposcopy. Materials & Methods: We conducted a single center prospective study which enrolled 112 patients with diagnosed or suspected cervical pathology who were examined at the Outpatient Colposcopy Clinic of Patras University Hospital, over a 7-months period. Patients were randomly assigned to one of the two groups. The interventional group received 1gr of paracetamol (acematiminofen) in pill form, 30 to 60 minutes before colposcopic assessment; the control group received no medication. At the end of consultation, all participants completed a 2-page questionnaire. Results: More patients of the interventional arm did not experience any pain at all during colposcopy compared with the control group. However, this difference was statistically not significant, probably because of the small number of patients. Moreover, there were no differences in mild and moderate pain rates between the interventional and control groups. Severe pain was only experienced by patients in the control group. Further data analysis from the first time as and for repeat colposcopy patients showed similar findings regarding pain intensity rates in the interventional and control group. When considering anxiety levels, no differences were observed between the two groups. Conclusion: The preliminary administration of low dose paracetamol in a pilot sample of colposcopy patients did not illustrate significant benefits in terms of experienced pain and anxiety levels.
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Fachetti-Machado, Giselle, Rosane Figueiredo-Alves, and Marise Moreira. "Performance of Conventional Cytology and Colposcopy for the Diagnosis of Cervical Squamous and Glandular Neoplasias." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 40, no. 07 (July 2018): 410–16. http://dx.doi.org/10.1055/s-0038-1666995.
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Objective To estimate the cytological and colposcopic performances for the diagnosis of cervical neoplasias. Methods Cross-sectional retrospective study with data from patients' charts. The participants underwent colposcopy, guided biopsies, and excision when needed. The cytological and colposcopic categorization followed the Bethesda System and the international colposcopic terminologies. The cytology and colposcopy performances were evaluated by sensitivity (SE), specificity (SP), positive predictive value (PPV), and negative predictive value (NPV) analyses with 95% confidence interval (95% CI). Results From 1,571 participants, a total of 1,154 (73.4%) were diagnosed with cervical squamous intraepithelial neoplasia grade 2 or worse (CIN 2+), 114 (7.2%) with adenocarcinoma in situ or worse (AIS+), 615 (39.2%) presented atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion or worse (ASC-H+) cytology, and 934 (59.4%) presented major or suspicious for invasion colposcopic abnormalities. The SE, SP, PPV, and NPV of ASC-H+ for diagnoses of CIN 2+ and AIS+ were, respectively: 44% (95% CI: 41–47) and 72% (95% CI: 67–76), 79% (95% CI: 77–81) and 79% (95% CI: 75–83), 88% (95% CI: 87–90) and 55% (95% CI: 50–60), and 28% (95% CI: 26–31) and 88% (95% CI: 85–91). The SE, SP, PPV, and NPV of major or suspicious for invasion colposcopic abnormalities for diagnoses of CIN 2+ and AIS+ were, respectively: 62% (95% CI: 60–65) and 86% (95% CI: 83–89), 59% (95% CI: 57–62) and 59% (95% CI: 55–64), 85% (95% CI: 83–87) and 44% (95% CI: 40–49), and 29% (95% CI: 27–32) and 92% (95% CI: 89–94). Conclusion The SE analyses results of ASC-H+ and major or suspicious for invasion colposcopic abnormalities were higher for diagnoses of glandular neoplasias. These results confirm the role of cytology in identifying women at risk who will have their final diagnoses settled by colposcopy and histology.
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Marcos Lopes, Ana Cristina, Adriana Bittencourt Campaner, and Laílca Quirino Henrique. "Prevalence of High-Grade Intraepithelial Neoplasia in Patients with Cytology Presenting Atypical Squamous Cells of Undetermined Significance." Acta Cytologica 60, no. 2 (2016): 139–44. http://dx.doi.org/10.1159/000446206.
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Objectives: To evaluate the prevalence of histological high-grade lesions and cervical cancer in patients with ASCUS cytology. Methods: This is a cross-sectional prospective study involving 703 women with a uterus and atypical squamous cells of undetermined significance (ASCUS). The patients were submitted to a colposcopy and underwent a guided biopsy when changes on the colposcopy were detected. Results: The findings revealed 456 (64.9%) women with a normal colposcopy and 247 (35.1%) with colposcopic abnormalities. The biopsy results were: cervical intraepithelial neoplasia grade 1 (CIN 1) in 51 (20.6%) patients, CIN 2 in 11 (4.5%) patients, CIN 3 in 8 (3.2%) patients, and a negative result in 177 (71.7%) patients; no cases of cancer were detected. Tallying of 456 normal colposcopies and 177 negative biopsies yielded a total of 90.04% negative exams. Furthermore, around 7.2% (51/703) of the patients exhibited CIN 1, a lesion associated with a high potential for regression. The biopsy results were not associated with patient age or menopausal status. Conclusion: We conclude that cytological surveillance of patients with ASCUS is feasible and safe given the low risk of CIN 2/3 or cervical cancer.
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Rao, Rohini, Ragweshwar Jyoti, Payal Gupta, PL Sood, and Neelam Parasher. "Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India." Journal of SAFOMS 1, no. 1 (2013): 21–23. http://dx.doi.org/10.5005/jp-journals-10032-1005.
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ABSTRACT Objectives To determine the correlation between cytology, colposcopy and histopathology, individually and in combination, in high-risk patients for detection of early cancer of the cervix. Materials and methods A total of 200 high-risk patients in the age groups of 35 to 60 years were included in the study. Pap smear, colposcopy and colposcopically directed biopsies were taken from the suspicious area. Results Sensitivity, specificity and positive predictive value of Pap smear are 65.2, 96.3 and 89.3% respectively. Correlation between cytology and colposcopy was 81%, between colposcopy and histopathology was 90.6%, between cytology, colposcopy and histopathology was 90.6% and between cytology, colposcopy and histopathology was 87.3%. Conclusion Combination of various methods increases the diagnostic accuracy over that of each method separately. How to cite this article Jyothi R, Gupta P, Rao R, Sood PL, Parasher N. Correlation between Colposcopy, Cytology and Histopathology in High-risk Patients for Cervical Cancer in Perimenopausal Women in Himachal Pradesh, India. J South Asian Feder Menopause Soc 2013;1(1):21-23.
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García-Carrasco, Mario, Claudia Mendoza-Pinto, Socorro Méndez-Martínez, Ariadna Rodríguez-Reyes, Pamela Munguía-Realpozo, Alejandro Taboada-Cole, Verónica Vallejo-Ruiz, et al. "Comparing cytology, colposcopy and human papillomavirus cervical intraepithelial lesion screening methods in women with systemic lupus erythematosus." Lupus 29, no. 9 (June 5, 2020): 1060–66. http://dx.doi.org/10.1177/0961203320931176.
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Objective To compare the performance of cytology, colposcopy and human papillomavirus in detecting cervical intraepithelial lesions in women with systemic lupus erythematosus. Methods Papanicolaou smears (normal, low-grade squamous intraepithelial lesion, high grade squamous intraepithelial lesion), colposcopy findings, human papillomavirus and co-testing (Papanicolaou smear + human papillomavirus) were compared with cervical biopsy findings in women with systemic lupus erythematosus. Sensitivity, specificity, false-positive and false-negative rates, positive and negative predictive values and likelihood ratios of cytologic smears, colposcopy findings, human papillomavirus and co-testing were determined. Results Cytology and colposcopy were performed in 170 systemic lupus erythematosus women (mean age and disease duration of 43.7±12.1 years and 9.7±5.3 years, respectively) and biopsies were performed in 55 patients (38.2% normal, 60.0% low-grade squamous intraepithelial lesion and 1.8% high grade squamous intraepithelial lesion). The sensitivity, specificity, positive predictive value and negative predictive value of cytology were 14.7% (95% confidence interval 5.5–31.8%), 95.2% (95% confidence interval 74.1–99.7%), 83.3% (95% confidence interval 36.4–99.1%) and 40.8% (95% confidence interval 27.3–55.7%), respectively. The sensitivity, specificity and positive predictive value of colposcopy findings were 100.0% (95% confidence interval 87.3–100.0%), 0.0% (95% confidence interval 0.0–19.2%) and 61.8% (95% confidence interval 47.7–74.2%), respectively. The sensitivity and specificity of co-testing were 8.0% (95% confidence interval 1.3–27.5%) and 100.0% (95% confidence interval 71.6–100.0%). The positive predictive value and negative predictive values were 100.0% (95% confidence interval 19.7–100.0%) and 36.1% (95% confidence interval 33.5–38.8%), respectively. Conclusions In systemic lupus erythematosus patients, colposcopy impressions were more sensitive than cytology and co-testing. However, cytology and co-testing were the most specific tests. The results should be interpreted with caution due to the small sample size.
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Jesmin, S., Shroddha Nivedita Paul, Some Rose Pervin, and Forida Islam. "Prevalence of CIN by Colposcopy among the Patient of Clinically Unhealthy Cervix in a Tertiary Care Hospital in Rajshahi." TAJ: Journal of Teachers Association 26 (November 28, 2018): 3–7. http://dx.doi.org/10.3329/taj.v26i0.37577.
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We evaluate 600 patient with clinically unhealthy cervix with colposcope and cervical punch biopsy was taken from each patient for further evaluation.Patient & Methods: This is a cross sectional descriptive study carried out in colposcopy center of RMCH from January to December 2014. We reviewed all patient aged 18 to 60 years having clinically unhealthy cervix, who attended colposcopy center during study period.Results: Among 600 patient with unhealthy cervix 150 patient present with cervical erosion that is 25% patient present with erosion, 96 patient presented with congestion that is 16% with congestion, 30 patient presented with polyp that is 5%, 84 patient presented with excessive P/V discharge that is 14%, 73 patient with hypertrophied cervix that is 12%, patient with hypertrophied cervix and among all patient 96 patient was colposcopically diagnosed as CIN (72 with CIN-I, 12 with CIN-II, 12 with CIN-III, that is 16% patient has CIN, in 97 patient findings was unsatisfactory. Histopathologically 72 has CIN, among these 48 has CIN-I, 18 with CIN-II, & 6 with CIN-III that is 12% patient was histopathologically diagnosed as CIN. And 6 patient diagnosed as invasive carcinoma.Conclusion: So from this study we get a good information regarding prevalence of CIN among unhealthy looking cervix. And there is good correlation between colposcopy & histopathology findings.TAJ 2013; 26: 3-7
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Miranda, Cleine Aglacy Nunes, Érika Galvão Lima, Diego Breno Soares de Lima, Ricardo Ney Oliveira Cobucci, Maria da Conceição de Mesquita Cornetta, Thales Allyrio Araújo de Medeiros Fernandes, Paulo Roberto Medeiros de Azevedo, Jenner Chrystian Veríssimo de Azevedo, Josélio Maria Galvão de Araújo, and José Veríssimo Fernandes. "Genital Infection with Herpes Simplex Virus Types 1 and 2 in Women from Natal, Brazil." ISRN Obstetrics and Gynecology 2014 (March 11, 2014): 1–8. http://dx.doi.org/10.1155/2014/323657.
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Objective. To evaluate the prevalence of HSV-1 and HSV-2 in pregnant and nonpregnant women, testing the correlation between DNA of the viruses with colposcopic and/or cytological changes, and evaluate association with sociodemographic characteristics and sexual activity. Methods. Included in this study were 106 pregnant and 130 nonpregnant women treated at primary health care units of Natal, Brazil, in the period 2010-2011. The patients were examined by colposcopy, and two cervical specimens were collected: one for cytology examination and another for analysis by PCR for detection of HSV-1 and HSV-2. Results. HSV-1 alone was detected in 16.0% of pregnant and 30.0% of nonpregnant women. For HSV-2, these rates were 12.3% and 15.5%, respectively. HSV-2 had a higher correlation with cytology and/or colposcopy changes than HSV-1 did. Genital HSV-1 infection was not associated with any of the variables tested, whereas HSV-2 infection was associated with ethnicity, marital status, and number of sexual partners. Conclusions. The prevalence of HSV-1 was higher than that observed for HSV-2 in both pregnant and nonpregnant women. The genital infection by HSV-2 was higher in women with changed colposcopy and/or cytology, and it was associated with ethnicity, marital status, and number of sexual partners.
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Katz, Ingrid T., Lisa M. Butler, Tamaryn L. Crankshaw, Alexi A. Wright, Karen Bramhill, Dominick A. Leone, Janet Giddy, and Sean Mould. "Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates." Journal of Global Oncology 2, no. 6 (December 2016): 375–80. http://dx.doi.org/10.1200/jgo.2015.002469.
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Purpose To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. Materials and Methods We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for < 3 months were excluded. Data were abstracted from electronic records and paper charts to assess rates of cervical abnormalities detected on Pap smears as well as time to colposcopy. Results During the study period, 432 women (93.5%) had at least one evaluable Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively. Conclusion In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.
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Shrestha, Junu, Dilasma Gharti Magar, and Chandani Pandey. "Cervical Intraepithelial Lesions in Women with Persistent Inflammatory Smear on Pap Smear: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 59, no. 241 (September 11, 2021): 848–52. http://dx.doi.org/10.31729/jnma.7011.
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Introduction: Persistent inflammatory smear is a benign finding on pap test but is associated with premalignant lesion of the cervix. Further evaluation is therefore necessary. This study was done to determine the prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear. Methods: This is descriptive observational study conducted in Department of Obstetrics and Gynaecology of tertiary care centre of Nepal from 15th May 2020 to 14th May 2021 after obtaining ethical clearance from Institutional Review Board (Reference no MEMG/IRC/338/GA). Women with two consecutive pap smear reports showing inflammatory findings were enrolled. Colposcopy was performed and Modified Reid’s colposcopic index was used to grade the lesions. Colposcopic guided biopsy was taken and tissue sent for histopathology for abnormal colposcopic lesions. Data analysis was done using Statistical Package for Social Sciences version 21 and frequency and percentages were used to present data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 115 women, 57 (49.5%) at 95% Confidence Interval (40.37-58.63) had Cervical Intraepithelial lesions. Among them 48 (41.7%) had low grade intraepithelial lesions and 9 (7.8%) had high grade lesions on colposcopy. Conclusions: The prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear on pap was higher in our study compared to other studies.
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Apiwattanasevee, Warangkana, Nida Jareemit, and Boonlert Viriyapak. "Spontaneous Regression Rate of Low Grade Cervical Intraepithelial Lesions Diagnosed from Colposcopy." Journal of Health Science and Medical Research 36, no. 3 (August 20, 2018): 233. http://dx.doi.org/10.31584/jhsmr.2018.36.3.16.
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Objective: To evaluate the spontaneous regression rate and its associated factors of low grade intraepithelial lesionsafter colposcopy in Thai women.Material and Methods: A retrospective study of the data of Thai women, not younger than 21 years old with liquidbased cervical cytology of atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL), who had received colposcopic examination with histologically proven cervical intraepithelial neoplasia grade 1 (CIN1) or human papillomavirus (HPV) infection. All patients underwent cytologic tests as the follow-up method for at least 2 years at the Gynecology Clinic, Siriraj Hospital. Analyzed data included patient characteristics, cervical cytological and pathological results, colposcopic findings and evidence of cytological regression. The correlations between each variable and regression status were then measured.Results: Data of a total of 154 patients who completed 2 years of follow-up were reviewed. One hundred and two patients had cytologic regression, showing a regression rate of 66.2%. There was 31.8% persistent abnormal cytology, and 2.0% progressed to high-grade cervical intraepithelial lesions. All patients with persistence or progression of cervical cytology had no invasive lesion. The only factor significantly related to cytologic regression was the pattern of colposcopic findings (p-value=0.041). The HPV-specific lesion on the colposcopy showed the significant pattern with an odds ratio of 3.5 (95% confidence interval=1.2-10.1, p-value=0.028).Conclusion: Women who had initial cervical cytology of ASC-US or LSIL with colposcopic histological confirmation of CIN1 or HPV infection had spontaneous regression, about two-thirds within 2 years of follow-up time. Thus, conservative management in these patients should be considered.
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Parvin, Suraiya, Nazneen Kabir, Yeasmin Samad Lipe, Khaleda Nasreen, and KM Nurul Alam. "Correlation of pap smear and colposcopic finding of cervix with histopatholgiocal report in a group of patient attending in a tertiary hospital." Journal of Dhaka Medical College 22, no. 1 (July 7, 2013): 39–44. http://dx.doi.org/10.3329/jdmc.v22i1.15604.
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Objective: To correlate Paps smear and colposcopic finding of cervix with histopathological report of abnormal area of cervix in a group of patient attending a tertiary hospital. Methods: It was a cross-sectional prospective study done in one year period from January to December 2007 in Colposcopy Clinic of Institute of Child and Maternal Health (ICMH) Hospital, Dhaka. The study carried out including fifty two female patients having clinically unhealthy cervices as in the form of hypertrophy, erosion, congestion or bleeds on touch or having positive pap smear found during P/V or P/S examination, attending gynaecology out patient department of ICMH Hospital after fulfilling all the inclusion criteria. Result: The present study showed a correlation between cervical cytology and colposcopically directed biopsy, the correlation was accurate within one grade in 39 of 51 cases (76.16%) (as cytology was not done in one case). Other studies showed cytologic accuracy (within one level of histologic finding) to about 83% and 88% cases. Conclusion: The study done here shows excellent correlation between findings of colposcopy with that of histopathology of guided biopsy. It also confirms the diagnostic value of colposcopy in the management of women with abnormal cervical cytology with squamous atypia. DOI: http://dx.doi.org/10.3329/jdmc.v22i1.15604 J Dhaka Medical College, Vol. 22, No. 1, April, 2013, Page 39-44
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Nanda, Anuja, Neeta Bansal, Vineeta Gupta, Arti Sharma, Archna Tandon, and Mini Singhal. "Correlation between Cytology, HPV-DNA Test and Colposcopy in Evaluation of Cervical Intraepithelial Lesions." Journal of SAFOMS 2, no. 2 (2014): 71–74. http://dx.doi.org/10.5005/jp-journals-10032-1045.
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ABSTRACT Objectives The present study was undertaken to correlate cytology, HPV-DNA test and colposcopy in evaluation of cervical intraepithelial lesions. Materials and methods Patients were subjected to Pap smear, HPV-DNA detection, colposcopy and directed cervical biopsy if required. The various screening methods were correlated and evaluated by standard statistical methods. Observations A total of 324 patients were included in the study. Colposcopy was done in 263, Pap smear in 214, HPVDNA in 100 and HPE in 116 patients. Sensitivity and specificity of Pap smear test, colposcopy and HPV-DNA testing were calculated to be 66.66, 93.54, 86.84, 86.32, 90 and 84.61% respectively. Their positive predictive value and negative value were 75, 90.60, 67.34, 95.28, 69.23 and 95.66% respectively. The percentage of false negative and false positive were calculated to be 33.33, 6.45, 8.95, 13.67, 10 and 15.38% respectively. Conclusion Various screening methods for evaluation of cervical intraepithelial lesions are complimentary to each other and need to be carried out depending on the clinical findings, patient's convenience and compliance, facilities and set-up available. How to cite this article Gupta V, Tandon A, Nanda A, Sharma A, Bansal N, Singhal M. Correlation between Cytology, HPV-DNA Test and Colposcopy in Evaluation of Cervical Intraepithelial Lesions. J South Asian Feder Menopause Soc 2014;2(2):71-74.
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Nessa, Kamrun, Khadija Nazneen, Najmin Munni, Runa Laila, Farhana Islam, and Sheikh Rabeya Akhter. "Role of Visual Inspection of Cervix with Acetic Acid (VIA) in Detecting Precancerous Lesions of Cervix." Journal of Enam Medical College 4, no. 1 (February 23, 2014): 39–44. http://dx.doi.org/10.3329/jemc.v4i1.18068.
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Background: Carcinoma of cervix is the most common malignancy in female and a major public health problem worldwide. It is the leading cause of death from cancer among women in low resource settings. In Bangladesh, mortality rate is high as most of the cases with cervical cancer are diagnosed in advanced stage. World Health Organization considers cervical cancer as a preventable disease as it can be identified in preinvasive stage. Considerable efforts have been given in detection and treatment of the condition all over the world. A number of cervical cancer screening tests are available. Among them, visual inspection of cervix with acetic acid is rational and can be competently performed by physicians with proper training. Objective: To find out the feasibility of the visual inspection of cervix with acetic acid for the detection of the precancerous lesions of the cervix in our country. Materials and Methods: This cross sectional, analytical study was carried out among the patients attending the outpatient department of Bangabandhu Sheikh Mujib Medical University (BSMMU) who were VIA positive and sent for colposcopy in the colposcopy clinic in the department of Obstetrics and Gynecology in BSMMU from June to December 2004. Two hundred samples were considered for this study. Results: Out of 200 cases, colposcopically 85% had CIN and invasive lesions, 4% had inflammatory lesions while 11% had normal findings. Colposcopy directed punch biopsy revealed positive lesions in 81%, 4% had inflammatory lesions while 15% had normal findings. Conclusion: The study concluded that VIA and colposcopy are the important methods in the evaluation of cervical premalignancy. VIA may be an important tool for screening of cervical cancer in low resource settings as it is simple, easy to perform and cost-effective. After screening, VIA positive cases must be referred for colposcopic evaluation. We can screen cervical cancer by VIA all over the country and thus reduce morbidity and mortality rate. DOI: http://dx.doi.org/10.3329/jemc.v4i1.18068 J Enam Med Col 2014; 4(1): 39-44
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Ungure, Anita, Jana Žodžika, Nellija Lietuviete, Dace Rezeberga, and Ilva Šenfelde. "Women's knowledge about risk factors, prevention and diagnostics of cervical precancerous changes at colposcopy clinic in Latvia." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 8 (July 26, 2018): 3091. http://dx.doi.org/10.18203/2320-1770.ijrcog20183296.
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Background: The incidence of cervical cancer in Latvia is one of the highest among European countries. An organized cervical cancer screening program in Latvia was introduced in 2009. Women’s knowledge and attitude regarding cervical cancer is the key component for successful prevention of this disease. The aim of this study was to evaluate women’s knowledge about the risk factors, prevention and diagnostic methods of precancerous and invasive disease of the uterine cervix in the main colposcopy clinic in Latvia and to compare women's knowledge before and after their first colposcopy visit.Methods: This was a cross sectional study where 100 women were included while attending their first colposcopy visit at Colposcopy Clinic of Riga East Clinical University Hospital. Study was performed in the period September 2017 to November 2017. Exclusion criteria were colposcopy follow-up examination and pregnancy. The most common reason for a planned colposcopy was suspected precancerous changes during cytology testing.Results: The most common information resources regarding reproductive health were gynaecologist (79%) and mass media (51%). Women knowledge about the risk factors of cervical precancerous changes were as follows: 30% marked smoking and 26% - early onset of the first sexual intercourse. 31% of women knew that vaccination against HPV is an effective prevention. 53% of women considered cervical cytology and 52% - colposcopy as a diagnostic method for precancerous changes. Higher number of women evaluated their general knowledge as sufficient after the visit (10% vs. 30%, p<0.05), but only smoking as a risk factor was recognized significantly more often (30% vs. 42%, p<0.05).Conclusions: Although current study presented specific population of women attending Colposcopy clinic because of suspected precancerous disease, less than a half of women knew risk factors, prevention and diagnostics of these changes. Overall women were satisfied with information they received during their first colposcopy visit, but afterward only knowledge about smoking as a possible risk factor improved significantly. It is important to improve women's knowledge about the meaning of prevention methods in order to increase the awareness of cervical cancer in Latvia.
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Byrom, J., P. D. J. Dunn, G. M. Hughes, J. Lockett, A. Johnson, J. Neale, and C. W. E. Redman. "Colposcopy Information Leaflets: What Women Want to Know and When They Want to Receive This Information." Journal of Medical Screening 10, no. 3 (September 2003): 143–47. http://dx.doi.org/10.1177/096914130301000309.
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Objectives: To evoluate whether the information leoflets produced by UK colposcopy clinics provide women with the information they desire and to determine when they would like to receive this information. Design: Questionnaire study and structured evaluation. Setting: The colposcopy clinic of a UK cancer centre. Participants: Forty-two women attending a pre-colposcopy counselling session and 100 consecutive women attending the colposcopy clinic. Methods: Thirty-eight standards derived from the concerns/questions asked by women attending a pre-colposcopy counselling session were used to assess locally produced colposcopy clinic leaflets from UK colposcopy clinics, the leaflets produced by the Royal College of Obstetricians and Gynaecologists and the National Health Service Cervical Screening Programme (NHSCSP), and two “leaflets” obtained from internet sites. The Gunning fog test was used to assess the leaflets' readability. A questionnaire survey of 100 women attending the colposcopy clinic was used to determine when women wanted to receive information about colposcopy. Main outcome measures: Percentage of questions answered by a given leaflet and Gunning fog scores for readability. Results: The information leaflets of 128 colposcopy clinics were received and assessed. Thirty-two clinics only sent women the NHSCSP leaflet. No leaflet answered all 38 questions. Less than half (36/100) of the leaflets answered more than 50% of the questions. In addition to the lack of advice given, different leaflets frequently gave conflicting advice. The average Gunning fog score was 9.7 (range 5.5–15.5). The majority of women (70%) wanted to receive information about colposcopy at or prior to the time of receiving their abnormal smear test result, although only 42% of women actually received information at this time. Conclusions: Many UK colposcopy clinics do not appear to be providing women with the information they require to understand their condition and the procedure that they are about to undergo. Furthermore, this information is often not provided at the appropriate time in the screening process.
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Bagga, Rashmi, Payal Keswarpu, Sarif Kumar Naik, Vidya Chandrasekhar, Lovi Gupta, and Soubhik Paul. "Feasibility of Using Mobile Smartphone Camera as an Imaging Device for Screening of Cervical Cancer in a Low-resource Setting." Journal of Postgraduate Medicine, Education and Research 50, no. 2 (2016): 69–74. http://dx.doi.org/10.5005/jp-journals-10028-1196.
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ABSTRACT Objective The aim of this study is to determine the feasibility of a screening method for cervical cancer using an application developed on smartphone to aid visual inspection with acetic acid. Materials and methods A prospective study was carried out in 230 women in the Department of Gynaecology, PGIMER, Chandigarh, India. These women were divided into two groups. Among the first group, screen positive women (n = 28) were examined by two gynecologists. In the second group (n = 202), health care workers screened women in a mobile van. The two groups were examined using the smartphone and digital colposcope. Abnormal findings were confirmed by liquid-based cytology and histopathology. The image quality of ColpPhon® was compared with colposcopic images as the gold standard. Kappa was used for comparison of ColpPhon® and colposcopic findings for final diagnosis. Results Among the 230 women screened, cervical intraepithelial neoplasia (CIN) was diagnosed in six cases by histopathology (CIN 2/3 in five and CIN 1 in one). These six women belonged to the group of 28 women examined in the colposcopy clinic. Both colposcope and ColpPhon® were able to identify these six women. The individual image quality parameters for ColpPhon® were slightly inferior to the colposcope. The overall image clarity had an agreement in 82% (184/225) as being either good or excellent. The diagnosis made on images acquired from each device had an agreement in 90% (208/230) of the cases. Conclusion This study demonstrates feasibility of incorporating a smartphone device to capture images of the cervix for improving cervical cancer screening in resource-poor countries. How to cite this article Bagga R, Suri V, Srinivasan R, Khandelwal N, Keswarpu P, Naik SK, Chandrasekhar V, Gupta L, Paul S. Feasibility of Using Mobile Smartphone Camera as an Imaging Device for Screening of Cervical Cancer in a Lowresource Setting. J Postgrad Med Edu Res 2016;50(2):69-74.
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Gamboa, Óscar, Mauricio González, Jairo Bonilla, Joaquín Luna, Raul Murillo, and Cervical Cancer Screening Study Group INC. "Visual techniques for cervical cancer screening in Colombia." Biomédica 39, no. 1 (March 31, 2019): 65–74. http://dx.doi.org/10.7705/biomedica.v39i1.4007.
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Introduction: Direct visual inspection for cervical cancer screening remains controversial, whereas colposcopy-biopsy is considered the gold standard for diagnosis of preneoplastic cervical lesions.Objectives: To determine the rates of cervical intraepithelial neoplasia grade 2 or more and of false positives for colposcopy and direct visual inspection.Materials and methods: Women aged 25-59 underwent direct visual inspection with acetic acid (VIA), Lugol’s iodine (VIA-VILI), and colposcopy. Punch biopsies were obtained for all positive tests. Using histology as the gold standard, detection and false positive rates were compared for VIA, VIA-VILI, and colposcopy (two thresholds). Sensitivity and false positive ratios with the corresponding 95% confidence intervals were estimated.Results: We included 5,011 women in the analysis and we obtained 602 biopsies. Positivity rates for colposcopy high-grade and low-grade diagnosis were 1.6% and 10.8%. Positivity rates for VIA and VIA-VILI were 7.4% and 9.9%. VIA showed a significantly lower detection rate than colposcopy with low-grade diagnosis as the threshold (SR=0.72; 95% CI 0.57-0.91), and significantly lower false positive rate (FPR=0.70; 95% CI 0.65-0.76). No differences between VIA-VILI and colposcopy low-grade threshold were observed. VIA and VIA-VILI showed significantly higher detection and false positive rates than colposcopy high-grade threshold. Sensitivity rates for visual inspection decreased with age and false positive rates increased. For all age groups, false positive rates for VIA and VIA-VILI were significantly higher than colposcopy.Conclusions: Detection rates for VIA-VILI similar to colposcopy low-grade threshold represent a chance to reduce cervical cancer mortality through see-and-treat approaches among women with limited access to health care. Lower detection rates suggest reviewing high-grade colposcopy findings as the threshold for biopsy in certain settings.
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Kavanagh, Anne M., Gigi Santow, and Heather Mitchell. "Consequences of Current Patterns of Pap Smear and Colposcopy Use." Journal of Medical Screening 3, no. 1 (March 1996): 29–34. http://dx.doi.org/10.1177/096914139600300108.
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Objectives— To describe age specific frequencies of Pap smear and colposcopy use in the Australian Capital Territory (ACT) and to estimate the cumulative effects of current patterns of use. Setting— Frequencies of Pap smear and colposcopy use were estimated for the financial year from 1 July 1989 to 30 June 1990. Eligible women were between the ages of 15 and 74, living in the ACT. Methods— Data collected from a 10% sample of subjects enrolled with Medicare and from the only public pathology laboratory in the ACT were used to estimate age specific frequencies. The expected number of deaths from cervical cancer in the ACT in the absence of a screening programme was estimated by applying Australian age specific mortality rates for cervical cancer between 1960 and 1964 to the 1989 ACT population. A life table approach was used to simulate the cumulative risk of colposcopy – given current age specific rates – on a hypothetical cohort of 1000, 15 year old women. Results— Forty four per cent (95% confidence interval (CI) 42.9 to 44.9) of women had a Pap smear and 2.5% had colposcopy (95% CI 2.4 to 2.6). Two and a half per cent of 15 to 24 year old women had colposcopy (95% CI 1.9 to 3.1). The ratio of women having Pap smears to women having colposcopy was 17.8:1 (95% CI 17.7 to 17.9). An estimated 247 women had colposcopy for every cervical cancer death; in the 15 to 24 year old age group this ratio was 47 900:1. A 15 year old woman exposed to current rates of colposcopy (adjusted for hysterectomy) has a 76.8% chance of having a colposcopy during her life time. Conclusions— Many more women will have colposcopy than will develop cervical cancer, which undermines the cost effectiveness of Australia's cervical cancer screening programme.
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Lygyrda, N. F. "Colposcopic assessment of the normal cervix in pregnant women." Infusion & Chemotherapy, no. 3.2 (December 15, 2020): 165–67. http://dx.doi.org/10.32902/2663-0338-2020-3.2-165-167.
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Background. Colposcopy in a pregnant woman is carried out to rule out the presence of invasive cervical cancer and to determine the need for targeted biopsy. Indications for colposcopy include pathological cytological smear, abnormal appearance of cervix, or bleeding of unknown origin.
Objective. To describe the features of colposcopic examination in pregnant women.
Materials and methods. Analysis of own experience and literature sources on this topic.
Results and discussion. Literature data indicate the reliability and safety of colposcopic examination of pregnant women. It should be noted that the examination of pregnant women requires a higher qualification from the colposcopist than the examination of non-pregnant women, although the assessment is based on the same principles. Simple colposcopy allows to assess the vascular pattern and color of the epithelium. For a more thorough assessment acetic acid and aqueous Lugol solution probes are carried out. The tasks of colposcopy are to identify the causes of deviations from the norm of cytological examination, to determine the location and boundaries of the pathological area, to choose the location of the targeted biopsy, to carry out medical manipulations within healthy tissues, and to monitor treatment results. To improve the planning of the necessary treatment options for excisions, a Nomenclature of colposcopic terms for cervix was created. Features of the cervix in pregnant women include the increased cervix vascularization, edema and hypertrophy of the papillae of the cervical canal, increased secretory activity of the cervical canal, eversion of the cervical mucosa, dehiscence of the cervical canal, increased metaplasia, deciduosis, prolapse of the vaginal walls. These physiological changes may cause overdiagnosis of pathological conditions. Thus, hypervascularization can mimic atypical vessels, and deciduosis – malignant tumors. Conversely, hypervascularization and bleeding, increased mucus production and prolapse of the vaginal walls can mask the manifestations of the disease, being the causes of underdiagnosis. The progression of eversion during pregnancy allows to visualize the lesion, which was previously localized in the cervical canal, better and better. Deciduosis in pregnant women is divided into decidual ectopia and decidual polyps of the cervical canal. The tumor-like form of deciduosis visually and colposcopically mimics exophytic tumors. The ulcer form is characterized by dense whitening when applying acetic acid, but is not stained with Lugol solution. Manifestations of the papillary form become the most pronounced after the acetic acid test. The vesicular form is the most common and most easily diagnosed by colposcopists. Decidual polyps become densely whitened during the acetic acid test, but unlike cervical cancer, blood vessels do not disappear. These polyps are not stained with iodine. Decidual polyps are usually localized in the areas of the original epithelium; they are multifocal and small in size. Instead, malignant tumors are localized within the atypical zone of transformation; they are single and have a bumpy uneven surface. Polymorphism and variety of lesions, young age, pregnancy, normal results of cytological examination are more typical for deciduosis. If the colposcopist is unsure of the benign nature of the process, a targeted biopsy should always be performed.
Conclusions. 1. The purpose of colposcopy in a pregnant woman is to rule out the presence of invasive cervical cancer and to determine the need for targeted biopsy. 2. Indications for colposcopy include pathological cytological smear, abnormal cervix appearance, or bleeding of unknown origin. 3. Physiological changes during pregnancy can be the cause of hyper- and hypodiagnosis of pathological conditions. 4. If the colposcopist is unsure of the benign nature of the process, a targeted biopsy should always be performed.
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Gohil, Ami M., Sanjay Ponde, Poorvi Agrawal, and Himadri Bal. "A study of evaluation of unhealthy cervix by various diagnostic modalities." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 1 (December 26, 2019): 82. http://dx.doi.org/10.18203/2320-1770.ijrcog20196001.
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Background: This study was carried out to evaluate cases of unhealthy cervix by using Pap (Papanicolaou) smear, colposcopy and cervical biopsy and to arrive at a definitive diagnosis. It correlated the findings of Pap smear, colposcopy and histopathology. It is important to strictly implement the screening program and spread awareness of the disease symptoms and its management to reduce the overall incidence of morbidity and mortality reported due to cervical cancer.Methods: A total 120 patients satisfying the inclusion/exclusion criteria were recruited for the study and informed consent was taken from all the participants. Pap smear was taken for all the cases. Then cases were subjected to colposcopy followed by biopsy. All the findings were correlated and analyzed. The findings of Pap smear and colposcopy were correlated with the gold standard of histopathology.Results: The sensitivity and specificity of Pap smear and colposcopy with respect to cervical biopsy were 53.1% and 98.7%, 87.87% and 72.72% respectively. Colposcopy had higher sensitivity and lower specificity than Pap smear for screening of cancer cervix.Conclusions: Cervical cancer is one of the preventable and highly curable conditions when diagnosed in the precancerous stage. The incidence of deaths resulting from cervical cancer can be brought down with adequate cervical cancer screening. Colposcopy and colposcopy directed biopsy should be done along with Pap smear in screening for early detection of cervical cancer since the accuracy of detection of cervical abnormalities is higher when these two methods are used complementarily.
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Bhattachan, Kabin, Ganesh Dangal, Aruna Karki, Hema Kumari Pradhan, Ranjana Shrestha, Sharmila Parajuli, Rekah Poudel, Nishma Bajracharya, and Kenusha Tiwari. "Evaluation of Abnormal Cervix with Visual Inspection under Acetic Acid and Colposcopy." Journal of Nepal Health Research Council 17, no. 01 (April 28, 2019): 76–79. http://dx.doi.org/10.33314/jnhrc.v17i01.1809.
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Background: Cervical cancer is a major public health problem especially in developing countries. It can be prevented through implementation of routine screening program. There are different screening methods but their efficacy are still questionable. So the purpose of this study is to evaluate the efficacy of visual inspection of cervix with acetic acid and colposcopy to detect precancerous lesion in women with clinically unhealthy or abnormal cervix.Methods: Forty patients with abnormal cervix (35) and abnormal pap smear results (5) were enrolled for the study in outpatient department of Kathmandu Model Hospital. Patients were evaluated with visual inspection of cervix with acetic acid and colposcopy in the same sitting. Cervical punch biopsy were taken from suspected lesion or from four quadrant if colposcopy findings were normal and sent for histopathological examination. The finding of visual inspection of cervix with acetic acid and colposcopy were correlated with histopathological finding and compared with each other.Results: The age of participants ranged from 24 to 68 years with mean age of 38.17 years and mean parity of 2.25. visual inspection of cervix with acetic acid and colposcopy were positive in eight (20%) and ten (25%) respectively. There were five (12.5%) cases of histopathologically proven lesion. The sensitivity of visual inspection of cervix with acetic acid and colposcopy were 80% and 100 % respectively and that of specificity were 88.5% and 85.5%.Conclusions: visual inspection of cervix with acetic acid is an effective screening tool with comparable sensitivity and specificity. It can be used as alternative screening methods especially in low income resource countries where the burden of disease is high.Keywords: Cervical cancer; Colposcopy; screening; VIA.
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Joarder, Mita, Shirin Akter Begum, Md Rasel Ahmad, Md Immam Hossin, Shanjida Islam, and Md Abdullah Al Harun. "Effects of Human Papillomavirus Infection with Pre-invasive Cervical Lesions: Bangladesh Perspectives." Bangladesh Journal of Obstetrics & Gynaecology 33, no. 1 (September 22, 2019): 5–10. http://dx.doi.org/10.3329/bjog.v33i1.43267.
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Background: Cervical cancer remains a major public health problem worldwide – particularly in less developed countries. Around 85% of their new cases and 86% of deaths occur in less development countries (IARC, 2012). In Bangladesh, Cervical cancer is the second most common disease among female with an estimated 11,956 new cases and 6,582 deaths in 2012. Objectives: The present study was undertaken to identify the Effects of Human Papillomavirus infection with Pre-invasive cervical lesions in Bangladesh.
Methods: This cross sectional study was carried out at the colposcopy clinic of Gynaecology and Obstetrics department of Bangabandhu Sheikh Mujib Medical University during the study period January 2015 - December 2015. A total of 65 consecutive women with VIA +ve cases of all three grades of CIN (CIN I, CIN II, CIN III) were enrolled in this study. Women having invasive cervical disease and women who not interested were excluded from this study.
Results: More than one third (35.3%) patients were in 3rd decade. More than one third (35.4%) patients had normal colposcopic findings followed by 23(35.4%) was CIN I, 11(16.9%) was CIN II and 8(12.3%) was CIN III. Majority (42.6%) patients was found CIN I, 11(26.1%) was CIN II, 8(19.4%) was CIN III and 5(11.9%) had normal in Histopathology. CIN I histopathological finding was found 18 cases, among them 8(44.4%) in positive HC-2/Viral load/ RLU index. In multivariate analysis CIN III was significantly increased 1.34 times in HC-2/Viral load/RLU index positive (human Papillomavirus) cases (95% CI 0.22 – 8.9%, <0.05). Validity test of benign HPV DNA test of the study women showed that HPV DNA had sensitivity 51.4%, specificity 92.9%, accuracy 69.2%, positive predictive values 90.5% and negative predictive values 59.1%. Benign Colposcopic finding had had sensitivity 86.5%, specificity 64.3%, accuracy 76.9%, positive predictive values 76.2% and negative predictive values 78.3%. CIN III significantly 1.34 times increased HC-2/Viral load/ RLU index positive (human Papillomavirus) in multivariate analysis.
Conclusion: From the findings of the study it was observed that colposcopy had a high sensitivity and optimum specificity; HPV DNA test had lower sensitivity and higher specificity. Colposcopic findings were closely associated with Histopathology, where the validity test was high when compared to HPV DNA test. So it can be concluded that the Colposcopy is a useful screening test for detection of cervical lesions and Human Papillomavirus is associated with pre-invasive cervical lessons. So the HPV DNA test can be used as a co-test with Colposcopy for screening of cervical lesions.
Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 5-10
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Cecchini, Silvia, Rita Bonardi, Anna lossa, Marco Zappa, and Stefano Ciatto. "Colposcopy as a Primary Screening test for Cervical Cancer." Tumori Journal 83, no. 5 (September 1997): 810–13. http://dx.doi.org/10.1177/030089169708300506.
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Aim and background To evaluate the cost effectiveness of screening by colposcopy compared to conventional cytology. Methods A prospective study was performed in the Florence District screening center on 3,000 consecutive women, self referring, who were examined by cytology and colposcopy in a blind fashion. Further assessment was based on cytologic report or on colposcopy-directed punch biopsy. Actual costs of the whole screening process were known. The cost effectiveness of different possible simulated screening scenarios was then determined. Results Overall, 18 high-grade lesions (CIN3 = 9, CIN2 = 9) were detected. Four different screening scenarios were compared, namely a) cytology alone, b) cytology + repeat smear for ASCUS (atypical squamous cells of undeterminate significance) cases, c) colposcopy + cytology for cases of condyloma at punch biopsy, and d) colposcopy alone. Although they had a higher cost per examined woman (a) = 17.98, b) = 19.40, c) = 23.86, d)= 22.10 US$), scenarios c) and d) had a higher relative sensitivity (a = 44.4, b = 61.1, c = 100, d = 88.8%) and a lower cost per high-grade lesion detected (a = 6,743, b = 5,291, c = 3,977, d = 4,144 US$). Conclusions Screening by colposcopy is a feasible procedure which is more sensitive and more cost effective than conventional cytologic screening. At least in those settings where access to cytopathology may be difficult, screening by colposcopy should be considered as a possible alternative.
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Patil, Kamal, G. Durdi, and KS Lakshmi. "Comparison of Diagnostic Efficacy of Visual Inspection of Cervix with Acetic Acid and Pap Smear for Prevention of Cervical Cancer: Is VIA Superseding Pap Smear?" Journal of South Asian Federation of Obstetrics and Gynaecology 3, no. 3 (2011): 131–34. http://dx.doi.org/10.5005/jp-journals-10006-1148.
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ABSTRACT Objectives To estimate diagnostic efficacy of visual inspection with acetic acid (VIA) in comparison to Pap smear. Methods This cross-sectional study was carried over a period of 24 months on 200 women attending colposcopy clinic at KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum, India. All women enrolled in study underwent Pap smear, VIA, colposcopy and biopsy. The sensitivity, specificity, PPV, NPV, false-positive rate and false-negative rate were calculated for VIA, Pap smear and colposcopy with biopsy as the reference standard. Results In our study, sensitivity and specificity of VIA were found to be 86.95% and 72.51% respectively, and that of Pap smear 37.68% and 92.36% respectively. Colposcopy showed higher sensitivity (94.20%) and specificity (94.65%). Conclusion VIA is a suitable primary screening procedure alternative to Pap smear as it has high sensitivity and negative predictive value.
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Bhatnagar, Kriti, and Kalpana Baghel. "Epidemiology of patients with bad cervix attending gynaecology OPD of a tertiary care centre in Western Uttar Pradesh, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, no. 3 (February 19, 2017): 791. http://dx.doi.org/10.18203/2320-1770.ijrcog20170471.
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Background: Cervical cancer is one of the biggest health problems of women around the world. An estimated 4,70,000 new cases are diagnosed worldwide annually with about 80% of these being in developing countries with India contributing to about a quarter of it. Pap smear and colposcopy are two non-invasive methods for screening of cervical cancer with varying sensitivity and specificity. This study uses these along with histopathology to find out premalignant lesions in women of rural western Uttar Pradesh, India and to find their correlation with various socio-demographic features.Methods: This prospective clinical study was carried out in department of Obstetrics and Gynaecology in Muzaffarnagar Medical College from 1st January 2012 to 31st December 2014. Those patients who fulfilled the inclusion criteria had their Pap smear done at first visit followed by colposcopy when cytology report was available. Colposcopically indicated biopsy was done only in those patients who had suspicious areas on colposcopy.Results: Out of total 500 women included in the study majority although having a bad cervix were having a normal pap smear (45%). LSIL and HSIL were present in 17.4% and 9.8% respectively. Squamous metaplasia was the most common abnormal finding seen in 12.2% of cases followed by acetowhite areas (7.6%). Only 137 patients who had abnormal colposcopic findings were subjected to biopsy.Conclusions: In present study it was found that increasing age, early age at coitarche and high parity are risk factors for high grade lesions. Colposcopy served as a tool to decrease the need for invasive procedure i.e biopsy.
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V, Surya Prabha, Kanaka Bushanam GVVS, Sakuntaladevi G, and Dharani Priya B. "Immunological study of cervical biopsy specimen for human papiloma virus." Journal of Medical and Scientific Research 2, no. 3 (April 2, 2014): 145–48. http://dx.doi.org/10.17727/jmsr.2014/2-026.
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Background: Cervical cancer is one of the most common cancers among women worldwide and its rates are higher in low and middle income countries. India is one not exemplified from the developing countries. Aims: The main aim of the present work is a preliminary prospective screening study to observe the incidence of human papilloma virus (HPV) virus in the specimens of cervical biopsy taken from the patients of gynecology department of Visakha Steel General Hospital, RINL, Visakhapatnam district. Screening procedures like Pap smear, Colposcopy Immunohistochemistry (IHC) were done to identify the prevalence of HPV. It is an effort to assess and also improving the quality of cervical cancer prevention and treatment services in Visakhapatnam district of North coastal Andhra Pradesh. Settings and design: This prospective study was conducted at the department of obstetrics and gynaecology, Visakha Steel General Hospital, RINL, Visakhapatnam district from January 2010 to December 2010. Materials and methods: The Pap test and colposcopic examination were conducted on 161 patients and IHC was done on 24 cervical biopsy patients. Results: The 87.58% of women was observed with abnormal Pap smear among that the severe dysplasia is around 10%. The abnormal cervix was seen by colposcopy is 89.44%. The 24 squamous metaplasia cases were subjected to IHC and 8 cases were found to be positive. Conclusion: Pap smear, colposcopy along with cervical biopsy for HPV can provide enough information for an accurate diagnosis of cervical cancer and also from the future course of action for the treatment of the patients.
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Zivadinovic, Radomir, Vekoslav Lilic, Biljana Djordjevic, Zorica Stanojevic, Aleksandra Petric, and Goran Lilic. "The role of colposcopy and typization of human papillomavirus in further diagnostic proceedings in patients with ASC-US cytological finding of the uterine cervix." Vojnosanitetski pregled 66, no. 8 (2009): 651–55. http://dx.doi.org/10.2298/vsp0908651z.
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Background/Aim. Bethesda system of classification of cytological findings was introduced in 2001 two subcategories in the category of atypical squamous cells (ASC) findings: ASC of undetermined significance (ASC-US) and ASC which cannot exclude high-grade intraepithelial lesions (ASC-H). The aim of our study was to assess a possible association of these two subcategories with pathologic biopsy finding and to find out the best further diagnostic proceedings. Methods. At the Clinic of Gynecology and Obstetrics, Nis 130 patients with ASC findings were analyzed. Colposcopy was performed in all study participants. Patients with pathological colposcopic findings underwent cervical biopsy. In 10 patients with pathologic histologic and 15 with benign findings human papilloma virus (HPV) typization was done using the Hybrid Capture method. Results. Patients with ASC-H finding had significantly more pathologic biopsies compared with patients with ASC-US finding (57.84: 20.72). Conclusion. Colposcopy was exhibited somewhat higher sensitivity compared to HPV typization (94.7 : 90), but lower sensitivity (79.27 : 86.6). The usage of HPV typization in the triage of patients with ASC cytologic smear induces statistically significant reduction of unnecessary percentage of cervical biopsies.
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Dimitriadi, T. A., D. V. Burtsev, and E. A. Dzhenkova. "Clinical factors of development of squamous intraepithelial cervical lesions of high grade in patients with papillomavirus infection." Research and Practical Medicine Journal 7, no. 2 (June 25, 2020): 22–29. http://dx.doi.org/10.17709/2409-2231-2020-7-2-2.
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Purpose of the study. To assess the chances of development of squamous intraepithelial cervical lesions of high degree (H‑SIL) in patients infected with human papillomavirus (HPV).Patients and methods. 75 HPV positive patients. The main group — with a histological diagnosis of H‑SIL (n=50), the control group — with a histological diagnosis without H‑SIL (n=25). Liquid-based cytology, colposcopy, cervical excision; HPV test, diagnosis of sexually transmitted infections — PCR in real time; a comprehensive bacteriological study. Assessment tool interconnections — odds ratio, categorical data analysis — statistical packages STATISTICA 6.0 and SPSS 22 "Statistical Package for the Social Sciences".Results. In the age group up to 30 years, the chances of H‑SIL development are 26 times higher, 30–40 years — 38 times higher compared to patients over 50 years (p<0.05). With a menstrual cycle of more than 35 days, the chances of H‑SIL development are 71 times greater than in patients with a normal menstrual cycle (p<0.05).Comparison of the chances of the presence of abnormal colposcopic patterns — the presence of significant lesions related to the II degree of colposcopic changes increases the chances of H‑SIL 8.4 times compared to the normal colposcopic pattern. The chances of development of H‑SIL in patients with colposcopy results of minor lesions (I degree), do not differ from those who have a normal colposcopic picture (p>0.05). The presence of chronic inflammatory diseases of the pelvic organs. Earlier treatment of cervical diseases by destruction reduces the risk of H‑SIL 0.08 times. The presence of chronic diseases of the pelvic organs increases the risk of H‑SIL 24 times (p<0.05).Conclusion. The group at greatest risk of having H‑SIL -women 30–40 years, whose menstrual cycle is more than 35 days, with significant lesions according to the results of colposcopic examination, chronic diseases of the pelvic organs, which had not previously been carried out destruction of the cervix.
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Phan Ngoc Khuong, Cat, Tien Tran Van, Quynh Nguyen Ngoc, Tu Ly Anh, Dung Tu Tuyet, and Anh Vu Quoc. "Segmentation of blood vessels in colposcopic images using polarized light and Sauvola thresholding." Science & Technology Development Journal - Engineering and Technology 3, no. 4 (December 27, 2020): first. http://dx.doi.org/10.32508/stdjet.v3i4.673.
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Cervical cancer is one of the two most common gynecological cancers in the world, including breast cancer. Signs of cervical disease are usually the presence of atypical epithelium, superficial bleeding or abnormal vascular proliferation. Most of these signs are directly related to cervical intraepithelial neoplasia (CIN) and cervical cancer. Currently, to detect epithelial lesions as well as to observe the shape of blood vessels, the main diagnostic methods used are colposcopy and visual examination. This method has low sensitivity and specificity because subjective factors still exist and the method does not clearly distinguish the shape of proliferating blood vessels. Therefore, in order to improve the efficiency of disease diagnosis, many studies applying image processing techniques to support auto-diagnosis have become topics of interest. However, studies that support automatic identify abnormal blood vessel shape and density are very limited. In this study, colposcopy images were recorded by digital colposcopes. These images are taken under polarized light to help reduce reflections from the surface and support for better image processing steps. Then, Sauvola threshold method is used to separate blood vessels on the surface of the cervix. It is combined with three different image preprocessing methods to enhance the contrast between the blood and the background. Finally, the sensitivity and specificity of these methods were calculated and evaluated. The results of the study set the stage for cervical blood vessel identification studies as well as cervical cancer assessment.
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Sayyah-Melli, Manizheh, Vahideh Rahmani, Elaheh Ouladsahebmadarek, Mehri Jafari-Shobeiri, Parvin Mostafa Gharabaghi, and Maryam Nooshin Vahidi. "Diagnostic Value of Pap Smear and Colposcopy in Non-benign Cervical Lesions." International Journal of Women's Health and Reproduction Sciences 7, no. 2 (May 10, 2018): 211–15. http://dx.doi.org/10.15296/ijwhr.2019.35.
Full textAbstract:
Objectives: Cervical cancer is a very common and lethal condition; however, owing to longstanding premalignant lesions, it is possible to prevent morbidity and mortality by screening tests. Pap smear, colposcopy, and biopsy are among the main modalities in this regard, however there is no consensus on the diagnostic utility of the first 2 methods. This study sought to examine the diagnostic utility of Pap smear, colposcopy, and cytology in evaluating the non-benign cervical lesions. Materials and Methods: A cross-sectional study was carried out between 2014 and 2016 in an out-patient setting at Alzahra teaching hospital of Tabriz University of Medical Sciences. After obtaining informed consent, all 315 participants with abnormal Pap test underwent colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as a gold standard and the diagnostic values of Pap smear and colposcopy were individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. Results: The mean age of patients was 38.49±10.31 years (17-68 years). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9.8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of Pap smear in revealing non-benign cervical lesions were 77.4%, 69.7%, 21.8%, 95.6%, 70.7%, and 2.55%, and for colposcopy, were 90.3%, 90.9%, 51.9%, 98.9%, 90.8%, and 99.2%, respectively. Conclusions: Based on our results, the colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited. Therefore, this method should not be considered as the main criterion for decision making.
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Shafi, M. I., J. A. Dunn, C. B. Finn, S. Kehoe, E. J. Buxton, J. A. Jordan, and D. M. Luesley. "Characterization of high- and low-grade cervical intraepithelial neoplasia." International Journal of Gynecologic Cancer 3, no. 4 (1993): 203–7. http://dx.doi.org/10.1046/j.1525-1438.1993.03040203.x.
Full textAbstract:
A need exists to characterize the various grades of cervical intrapithelial neoplasia (CIN), and attempt to differentiate between high- and low-grade lesions, that may have different behavioral and progressive potentials. The identification of patients with high- or low-grade CIN is useful, as it may allow identification of those patients that have true cancer precursors. Fifty patients referred for colposcopy with abnormal cytology were studied. Univariate analysis identified three factors as important predictors of histologic grade; the colposcopic opinion, lesion surface area and the index cytology (P< 0.005). Colposcopic opinion was associated with the index cytology (P< 0.01) and the lesion surface area (P< 0.005). Only the colposcopic opinion and the index cytologic smear appeared in the final model using a stepwise logistic regression analysis, indicating their independent prognostic importance in prediction of grade of abnormality in cervical intraepithelial neoplasia. The study demonstrates the value of colposcopic training and experience being necessary prior to utilizing excisional treatment methods if overtreatment is to be avoided.