Colposcopic evaluation of cervix with abnormal papsmear findings: prospective analytical study at our tertiary care centre
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20211534Keywords:
Colposcopy cervical intraepithelial neoplasia, Invasive cancer, Reid colposcopy indexAbstract
Background: Pap test has been successful in reducing the incidence of cervical cancer by 80% and mortality by 70%. Any women with a cytologic specimen suggesting the presence of HSIL on Pap smear should undergo colposcopy and dissected biopsy. Prevention of invasive cancer by early detection and treatment of cervical intraepithelial neoplasia (CIN) currently offers the most cost effective, long term strategy for cervical cancer control. The aim of study was to minimise disagreements and make colposcopy assessment quick, accurate and easy for follow-up.
Methods: Prospective analytical study of 300 gynaecological patients with abdominal Pap smear findings between June 2020 to Dec 2020 at R.N.T. Medical College, Udaipur. All of them were subjected to colposcopy and dissected biopsy from the abdominal areas. The incidence of CIN/invasive carcinoma was calculated by proportion/percentage.
Results: Incidence of invasive carcinoma was <1% but the incidence of premalignant lesion CIN was high (20.9%), CIN 2/3 and CIS were present in 6.9%.
Conclusions: Patients with persistent inflammation pap smear can harbour high proportion of CIN and hence these patients need further evaluation through colposcopy.
References
Moss SF, Blaser MJ. Mechanisms of Disease: Inflammation and origins of cancer. Nat Clin Pract Oncol.2005;2(2):907.
Kiviat NB, Paavonen JA, Brockway J, Critchlow CW, Brunham RC, Stevens CE. Cytologicmanifestations of cervical and vaginal infections. I. Epithelial and Inflammatory changes. JAMA.1985;253(7):989-96.
Atikson KM. benign cellular changes. In: Bonfigilo T, Erogen YS, editors. Gynaecologic Cytopathology. Philadelphia: Lppincot Raven Publishers. 1997;33-42.
ACOG Practice Bulletin. clinical management guidelines for Obstetrician and Gynecologist Cervical Cytology screening Obstet Gynecol. 2003;102:417-27.
Swinker M, Cutlip AC, Ogle D. A comparison of uterine cervical cytology and biopsy results: Indications and outcome of Colposcopy. J Fam Pract. 1994;38:404.
Seckin NC, Turban NO, Ozmen S, Ersan F, Avsar F, Ustin H. Routine evaluation of patients with persistent inflammatory cellular changes on Pap smear. Int J Gynaecol Obstet. 1997;59(1):25-9.
Wilson JD, Robinson AJ, Kinghorn SA, Hicks DA. Implications of inflammatory changes on cervical cytology. BMJ. 1990;300(6725):638-40.
Marchand L, Van Dinter M, Mundt M, Dingel W, Klein G. Current cervical cancer screening practices of Dane Country, Wsconsin Primary care clinicians. WMJ. 2003;102(3):35-40.
ACOG Committee on Practice Bulletins--Gynecology. ACOG Practice Bulletin no. 109: Cervicalcytology screening. Obstet Gynecol. 2009;114(6):1409-20.
Vassilakos P. Management of Suboptimal Cytologic smears: Persistent inflammatory smears. Acta Cytol. 1998;42(6):1481.
Mc Lachalan N, Patwardhan JR, Ayer B, Pacey NF. Management of suboptimal cytologic smears: Persistent inflammatory smears. Acta Cytol. 1994;38(4) :5316.
Frisch LE, Parmar H, Buckley LD, Chalem SA. Colposcopy of patients with Cytologic Inflammatory epithelial changes. Acta Cytol. 1990; 34(2):133-5.
Hammes LS, Tekamal RR, Naidu P, Edelweiss MI, Kirma N, Valentene PT, et al. Macrophages, inflammation and risk of cervical intraepithelial neoplaia (CIN) progression – Clinicopathological correlation. Gynecol Oncol. 2007;105(1):157-65.
