A study of evaluation of unhealthy cervix by various diagnostic modalities
Keywords:Cervical biopsy, Cervical cancer screening, Colposcopy, Pap smear
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.
Sen R. Principles and management of Cancer, 2004 B.I. Publication Pvt Ltd, New Delhi; 2004:1.
American College of Obstetricians and Gynecologists. Cervical cancer screening and prevention. Practice Bulletin No. 157. Obstet Gynecol; 2016:127:e1-20.
Dinshaw KA, Shastri SS, Patil SS. Cancer control programme in India: Challenges for the new millennium. Health Administrator. 2005;17(1):10-3.
Monsoneg J, Bosch FX, Coursaget P, Franco E, Frazer I, Sankaranarayanan R, et al. Mini review; cervical control, priorities and new directions. Int J Cancer. 2004;108:329-33.
ACOG practice bulletin clinical management guidelines for obstetricians-gynaecologists. 2003;102(45):417-27. Monsoneg. J, Bosch. F.X, Coursaget. P, Franco. E, Frazer. I et al; Mini Review; Cervical Control, Priorities and new Directions. Int J Cancer. 2004;108:329-33.
Nayani ZS, Hendre PC. Comparision and correlation of pap smear with colposcopy and histopathiology in evaluation of cervix. J Evol Med Dental Sci. 2015;4:9236-9247.
Joshi C, Kujur P, Thakur N. Correlation of Pap smear and colposcopy in relation to histopathological findings in detection of premalignant lesions of cervix in a tertiary care centre. Int J Sci Stud. 2015;3(8):55-60.
Kumari P, Desai RM, Lt. Col. Dr. Dinesh U. Screening for cancer of the uterine cervix with simultaneous use of Pap smear, Colposcopy and Colposcopy guided cervical biopsy: a prospective study. J Res Obstet Gynecol Infert. 2015;1(1):9-12.
Vidyadhar DS, Bhattacharya DA, Bohara DS, Dwivedi DA, Agarwal DA, Gangwar DD. Comparison and correlation of cytology, colposcopy and histopathology of premalignant lesions of cervix in rural women of Barabanki District. IOSR J Dent Med Sci. 2017;16(04):13-8.
Gandi SR, Vishwekar PS. A study on correlation of pap smear, colposcopy and colposcopic directed biopsy in women with unhealthy cervix. J Evol Med Dent Sci. 2017;6(7):515-8.