Comparative study of PAP smear and colposcopy with cervical biopsy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231919Keywords:
Cervical biopsy, Colposcopy, Pap smear, Unhealthy cervixAbstract
Background: Cervical Cancer is the second most common cancer among women worldwide approximately 80% of which occurred in developing countries. Out of all cervical cancer cases seen in the world, only 14% are in the developed countries, while about 86% occurs in the developing countries. The Cervical cancer is the leading cause of cancer in Indian women. Cervical cancer is usually preceded by a long phase of cytological changes, known as cervical intraepithelial neoplastic (CIN) and takes a long period of 15-20 years before the invasive cancer develops". Thus cervical cancer can be prevented if cellular changes are detected and treated in early stage. World Health organization considers cervical cancer as a preventable disease. This is because it can be diagnosed in its precancerous phase. So we have done study to study efficacy of pap smear and colposcopy. Comparative study of PAP smear and colposcopy with cervical biopsy in women with symptomatic/ unhealthy cervix.
Methods: All the high risk women of reproductive, perimenopausal and postmenopausal age group who presented with unhealthy cervix on naked eye examination, abnormal vaginal discharge, post coital bleeding, intermenstrual spotting/bleeding, cervix that bleeds on touch and abnormal uterine bleeding. An informed consent was obtained before performing Pap's smear and colposcopy. In case there was abnormal cytology report, the patient's cervical biopsy was done.
Results: The sensitivity of Pap smear is 50%, specificity is 86.6%, positive predictive value (PPV) 37.8%, and negative predictive value is 91.4%. The sensitivity of coloposcopy smear is 96.4, specificity is 39.53 and positive predictive value (PPV) 20.61%, negative predictive value is 98.55%.
Conclusions: Colposcopy is definitely more sensitive and accurate than pap smear. By combining Pap smear with colposcopy, we can maximize the sensitivity and specificity of cancer cervix screening.
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References
Jakobsson M, Gissler M, Paavonen J, Tapper AM. Long-term mortality in women treated for cervical intraepithelial neoplasia. BJOG. 2009;116:838-44.
Strander B, Hallgren J, Sparen P. Effect of ageing on cervical or vaginal cancer in Swedish women previously treated for cervical intraepithelial neoplasia grade 3: population based cohort study of long term incidence and mortality. BMJ. 2014;348:f7361.
Shrestha AD, Neupane D, Vedsted P, Kallestrup P. Cervical cancer prevalence, incidence and mortality in low and middle income countries: a systematic review. APJCP. 2018;19(2):319.
Canfell K., Sitas F., Beral V. Cervical cancer in Australia and the United Kingdom: comparison of screening policy and uptake, and cancer incidence and mortality. Med J Aust. 2006;185:482–6.
Quinn M., Babb P., Jones J., Allen E. Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics. BMJ. 1999;318:904–8.
Bruni L, Diaz M, Barrionuevo-Rosas L, Herrero R, Bray F, Bosch FX. Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis. Lancet Glob. Health. 2016;4(7):e453–63.
Verma I, Jain V, Kaur T. Application of bethesda system for cervical cytology in unhealthy cervix. J Clin Diagn Res. 2014;8(9):OC26-30.
Kalyankar VY, Kalyankar BV, Gadappa SN, Kute S. Colposcopic evaluation of unhealthy cervix and it’s correlation with Papanicolau smear in cervical cancer screening. Int J Reprod Contracept Obstet Gynecol. 2017;6:4959-65.
Shaki O, Chakrabarty BK, Nagaraja N. A study on cervical cancer screening in asymptomatic women using Papanicolaou smear in a tertiary care hospital in an urban area of Mumbai, India. J Fam Med Prim Care. 2018;7(4):652.
Thobbi VA, Khan F. Cervical cytology by Pap smear in reproductive population. Int J Reprod Contracept Obstet Gynecol. 2018;7:1988-92.
Kaveri SB, Khandelwal S. Role of Pap smear N cervical biopsy in unhealthy cervix. J Sci Innovat Res. 2015;4(1):4-9.
Kushtagi P, Fernandez P, Significance of Persistent Inflammatory, Cervical smears in Sexually active women of reproductive age. J Obstet Gynecol lndia. 2002;52(1)124-6.
Vaidya, Olaniyan OB. Validity of colposcopy in the diagnosis of early cervical neoplasia a review Reproductive Health 2002,6: 59 -69. Afr J Revi Repro Health 2002,6:59-69.
Sherwani RK, Khan T. Conventional pap smear and liquid based cytology for cervical cancer screeing. J Cytol. 2007;2(4):167-72.
Manjit SB, Rishu G, Anil KS, Manjit KM. Detection of abnormal cervical cytology in Papanicolaou smears. J Cytol. 2012;29(1):45-7.
Ramesh G, Sudha R, Jayashree AK, Padmini J. Colposcopic evaluation of the unhealthy cervix. J Clin Diagnost Res. 2012;6(6):1026-28.
Sachan PL, Singh M, Patel ML, Sachan R. A study on cervical cancer screening using pap smear test and clinical correlation. Asia-Pacific J Oncol Nurs. 2018;5(3):337.
Vincent M. Pap smear as a screening tool for evaluating cervical dysplasia and malignancy a hospital-based study. J Evolution Med Dent Sci. 2019;8(17):1368-71.
Padambhan H, Oumachigui A, Sankaran V, Rajaram P. A study of 80 cases of cervical intraepithelial neoplasia in a developing country. J Obs Gyn India. 1990;1:107-14.
Ashmita D, Shakuntala PN, Rao SR, Sharma SK, Geethanjali S. Comparison and correlation of PAP smear, colposcopy and histopathology in symptomatic women and suspicious looking cervix in a tertiary hospital care centre. Int J Health Sci Res. 2013;3(5):50-9.
Suguna M, Rajeshwar A, Pasula S. A study on pap smear and colposcopy in unhealthy cervix in women. Int J Med Sci Public Health. 2014;3(7):889-91.
Singh SL, Dastur NA, Nanavat MS. A comparision of colposcopy and the Papanicolaou smear: sensitivity, specificity and predictive value. Bombay Hospital J. 2000;42(3):447-51.
Garg R, Desai R. Cytologic and colposcopic evaluation of all symptomatic women at tertiary care centre. Int J Adv Med. 2017;4(3):799.
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