Colposcopic evaluation and papanicolaou smear in high risk groups and its correlation with histology
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20240124Keywords:
Cervical carcinoma, Colposcopy, Pap smearAbstract
Background: Cervical cancer is one of the most common gynaecologic neoplasms. PAP smear and colposcopy are used for its early detection. This study aims to find the correlation of colposcopic evaluation with Pap smear in cervical cancer screening and with histology.
Methods: All women attending the OPD with unhealthy cervix and abnormal symptoms, who gave written informed consent were included in the study. Pap smear cytological grading, colposcopic findings were recorded. Pap smear and colposcopy findings was compared with histopathology.
Results: The study included 73 patients. Pap smear was negative in more than half of the patients (56.2%), followed by atypical squamous cells of undetermined significance in 12 (16.4%), low-grade squamous intraepithelial lesion in 17 (23.3%), high-grade squamous intraepithelial lesion in 2 (2.7%) and squamous cell carcinoma in 1 patient (1.4%). The histopathology showed normal findings in 46 patients (63%), followed by CIN 1 in 11 (15.1%), CIN 2 in 6 patients (8.2%), CIN 3 and squamous cell carcinoma in 5 patients each (6.8%). Pap smear’s predictability of cervical malignancy showed that it had a sensitivity of 48.15, it’s specificity for identifying patients without cervical malignancy was 84.78%. Colposcopy’s predictability of cervical malignancy showed that it had a sensitivity of 88.89%, it’s specificity for identifying patients without cervical malignancy was 95.65%.
Conclusions: Colposcopy does seem to be better than Pap smear in diagnosing cervical carcinoma and also identifying patients without it.
References
De Freitas AC, Coimbra EC, Leitão M da CG. Molecular targets of HEPV oncoproteins: Potential biomarkers for cervical carcinogenesis. Biochim Biophys Acta - Rev Cancer. 2014;1845(2):91-103.
Spensley S, Hunter RD, Livsey JE, Swindell R, Davidson SE. Clinical Outcome for chemoradiotherapy in carcinoma of the cervix. Clin Oncol. 2009;21(1):49-55.
Bueno CT, da Silva CMD, Barcellos RB, da Silva J, dos Santos CR, Menezes JES, et al. Association between cervical lesion grade and micronucleus frequency in the Papanicolaou test. Genet Mol Biol. 2014;37(3):496-9.
World Health Organization. World Cancer Report, 2014. Available at: https://publications.iarc.fr/Non-Series-Publications/World-Cancer-Reports/World-Cancer-Report-2014. Accessed on 14th February 2023.
Peirson L, Fitzpatrick-Lewis D, Ciliska D, Warren R. Screening for cervical cancer: A systematic review and meta-analysis. Syst Rev. 2013;2(35):1-14.
Koutsky L, Holmes K, Critchlow C, Stevens C, Paavonen J, Beckmann A, et al. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. Int J Gynecol Obstet. 1993;41(3):326-6.
Mayrand M-H, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A, et al. Human papillomavirus DNA versus papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357(16):1579-88.
Zarchi MK, Binesh F, Kazemi Z, Teimoori S, Soltani HR, Chiti Z. Value of colposcopy in the early diagnosis of cervical cancer in patients with abnormal pap smears at Shahid Sadoughi Hospital, Yazd. Asian Pacific J Cancer Prev. 2011;12(12):3439-41.
Zarchi MK, Akhavan A, Fallahzadeh H, Gholami H, Dehghani A, Teimoori S. Outcome of cervical cancer in Iranian patients according to tumor histology, stage of disease and therapy. Asian Pacific J Cancer Prev. 2010;11(5):1289-91.
Ley C, Bauer HM, Reingold A, Schiffman MH, Chambers JC, Tashiro CJ, et al. Determinants of genital human papillomavirus infection in young women. J Natl Cancer Inst. 1991;83(14):997-1003.
Bernard E, Pons-Salort M, Favre M, Heard I, Delarocque-Astagneau E, Guillemot D, et al. Comparing human papillomavirus prevalences in women with normal cytology or invasive cervical cancer to rank genotypes according to their oncogenic potential: A meta-analysis of observational studies. BMC Infect Dis. 2013;13(1):1-11.
Krishnegowda S, MS V. Efficacy of colposcopy technique with Pap smear and histology in screening of cervical lesions. Int J Reprod Contraception, Obstet Gynecol. 2014;696-702.
Denny L, Kuhn L, Pollack A, Wainwright H, Wright TC. Evaluation of alternative methods of cervical cancer screening for resource-poor settings. Cancer. 2000;89(4):826-33.
Shastri SS, Dinshaw K, Amin G, Goswami S, Patil S, Chinoy R, et al. Concurrent evaluation of visual, cytological and HPV testing as screening methods for the early detection of cervical neoplasia in Mumbai, India. Bull World Health Organ. 2005;83(3):186-94.
Durdi GS, Sherigar BY, Dalal AM, Desai BR, Malur PR. Correlation of colposcopy using Reid colposcopic index with histopathology-a prospective study. J Turkish Ger Gynecol Assoc. 2009;10(4):205-7.
Vijay DA, Nath DJD, Deka DN. Comparison of role of colposcopic directed biopsy versus cytology in screening of pre invasive lesions and early detection of cervical cancer. Int J Med Res Rev. 2015;3(3):278-84.
Zarchi MK, Binesh F, Kazemi Z, Teimoori S, Soltani HR, Chiti Z. Value of colposcopy in the early diagnosis of cervical cancer in patients with abnormal pap smears at Shahid Sadoughi hospital, Yazd. Asian Pacif J Cancer Prevent. 2011;12(12):3439-41.
Pimple SA, Amin G, Goswami S, Shastri SS. Evaluation of colposcopy vs cytology as secondary test to triage women found positive on visual inspection test. Indian J Cancer. 2010;47(3):308-13.
Karimi-zarchi M, Zanbagh L, Shafii A, Shokouh T-Z, Teimoori S, Yazdian- Anari P. Comparison of Pap smear and colposcopy in screening for cervical cancer in patients with secondary immunodeficiency. Electron Phys. 2015;7(7):1542-8.
Moatamed NA, Le LT, Levin MR, Govind R, Apple SK. In Papanicolaou smears, benign appearing endometrial cells bear no significance in predicting uterine endometrial adenocarcinomas. Diagn Cytopathol. 2013;41(4):335-41.
Ashmita DS. Comparison and correlation of pap smear, colposcopy and histopathology in symptomatic women and suspicious looking cervix in a tertiary hospital care centre. Int J Heal Sci Res. 2013;3(5):50-9.
