Evaluate the effectiveness of various diagnostic criteria and treatment outcomes in colposcopy screening for cervical cancer in a tertiary care medical college and hospital
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232711Keywords:
Biopsy, Cervical cancer, Colposcopy, Diagnostic criteria, HPV DNA, LLETZ, ScreeningAbstract
Background: Cervical cancer is a significant health concern, particularly in developing countries like Bangladesh. This study aimed to evaluate the efficacy of diagnostic criteria and treatment outcomes in cervical cancer screening using colposcopy.
Methods: A retrospective study was conducted at Holy Family Red Crescent Medical College and Hospital, involving 110 female participants from January 2016 to December 2018. Inclusion criteria included women with symptoms such as vaginal discharge or postcoital bleeding, an unhealthy cervix or cervical erosion, abnormal Pap smear results, or positive VIA tests. Exclusion criteria were applied to ensure the integrity of the study.
Results: The study included participants ranging from 20 to 60 years old. Among the age groups, individuals aged 31-40 were the most represented, accounting for 43% of the total population. The second largest group was those aged 20-30, comprising 29% of the participants. The mean and SD of the population is 27.5±14.36. The most prevalent reasons for referral were an unhealthy cervix (31%), white discharge (26%), and cervical erosion (18%). Other indications included post-coital bleeding (9%), abnormal Pap smear results (11%), positive results for VIA (3%) and HPV DNA (2%). LLETZ was performed in 6% of cases for the treatment of abnormal cervical cells, while EC was conducted in 18% of cases to collect tissue samples from the endocervical canal.
Conclusions: The study highlights the importance of colposcopy in the screening process for cervical cancer, allowing for the detection of abnormalities and subsequent interventions. The findings contribute to the understanding of diagnostic criteria, treatment outcomes, and the need for early detection and prevention of cervical cancer.
References
Meites E, Kempe A, Markowitz LE. Use of a 2-dose schedule for human papillomavirus vaccination-updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2016;65(49):1405-8.
Meites E, Szilagyi PG, Chesson HW, Unger ER, Romero JR, Markowitz LE. Human papillomavirus vaccination for adults: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019;68(32):698-702.
Kim JJ, Burger EA, Regan C, Sy S.. Screening for cervical cancer in primary care; a decision analysis for the US Preventive Services Task Force. JAMA. 2018;320(7):706-14.
Polman NJ, Ebisch RM, Heideman DA, Melchers WJ, Bekkers RL, Molijn AC, et al. Performance of human papillomavirus testing on self-collected versus clinician-collected samples for the detection of cervical intraepithelial neoplasia of grade 2 or worse: a randomised, paired screen-positive, non-inferiority trial. Lancet Oncol. 2019;20(2):229-38.
Rodríguez AC, Schiffman M, Herrero R, Hildesheim A, Bratti C, Sherman ME, et al. Longitudinal study of human papillomavirus persistence and cervical intraepithelial neoplasia grade 2/3: critical role of duration of infection. J Natl Cancer Inst. 2010;102(5):315-24.
Smith HO, Tiffany MF, Qualls CR, Key CR. The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States-a 24-year population-based study. Gynecol Oncol. 2000;78(2):97-105.
Wang SS, Sherman ME, Hildesheim A, Lacey Jr JV, Devesa S. Cervical adenocarcinoma and squamous cell carcinoma incidence trends among white women and black women in the United States for 1976-2000. Cancer. 2004;100(5):1035-44.
Richa G, Ranjana D. Cystologic and colposcopic evaluation of all symptomatic women at tertiary care centre. Int J Adv Med. 2017;4(3):799-804.
Garg R, Desai R. Cytologic and colposcopic evaluation of all symptomatic women at the tertiary care centre. Int J Adv Med 2017;4(3):799-804.
Kumari M, Murari K, Kumari M. Role of colposcopy in management of cervical erosion in rural population of Eastern Bihar. Inter J Cur Res. 2016;8(11):41268-70.
Bangal VB, Patil NA, Gavhane SP, Shinde KK, Colposcopy guided management of cervical erosions in rural population. Sch J App Med Sci. 2014;2(1C):261-5.
Farideh D. Nahid A. A comparative study on colposcopy directed biopsy and Pap smear tests in patients with an abnormal Pap smear. Iranian J Pathol. 2006;1:13-6.
Pimple SA, Amin G, Goswami S, Shastri SS. Evaluation of colposcopy vs cytology as a secondary test in triage women was found to be positive on the visual inspection tests. Indian J Cancer. 2010;47(3):308-13.
Kavanagh AM, Santow G, Mitchell H. Consequences of the current patterns of the Pap smear and colposcopy use. J Med Screen. 1996;3(1):29-34.
Duraisamy K, Jaganathan KS, Bose JC. Methods of detecting cervical cancer. Adv Biol Res. 2011;5(4):226-32.
Massad LS, Jeronimo J, Katki HA, Schiffman M. The accuracy of the colposcopic grading for the detection of high-grade cervical intraepithelial neoplasia. J Low Genit Tract Dis. 2009;13(3):137-44.
