The correlation between colposcopy, cervical cytology and histopathology in the diagnosis and management of cervical lesions: a cross sectional study

Pooja Gupta, Mariyam Faruqi, Subrat Chandra, Sameer S. Shah, Rupita Kulshreshtha


Background: The study was undertaken to see the correlation between cervical cytology, histopathology and colposcopy in the diagnosis and management of various cervical lesions.

Methods: It is a cross sectional study conducted at a tertiary care hospital in Mumbai, in the department of obstetrics and gynecology from February 2007 to March 2008. A total 55 sexually active women were enrolled for the study who belonged to age group greater than 20 years with history of chronic leucorrhoea or post-coital bleeding/spotting, intermenstrual bleeding/spotting or examination findings of erosion, an unhealthy cervix, a lesion bleeding on touch or an abnormal or suspicious Papanicolaou smear. These women then underwent cytology, colposcopy and cervical biopsy.

Results: The accuracy of cytology when compared to colposcopy was 81.82%. The accuracy of colpo-histopathology was 83.6%. The combined accuracy was 76.36%.

Conclusions: The simultaneous use of cytological studies and screening colposcopy has been shown to increase the cervical cancer detection. Colposcopy offers an excellent tool in the hands of a gynaecologist to evaluate the uterine cervix and it is not possible to develop this kind of perspective by any other method.


Cervical cancer screening, Colposcopy, Female genital tract malignancy, Histopathology, Pap smear

Full Text:



Chhabra S. Modes and means of early diagnosis of pre-cancerous lesions of cervix, some glimpses. J Obst Gynae India. 2000;50:32-7.

Pandey K, Ajay B. Cancer cervix - need for mass surveillance program specially in rural areas. J Obst Gynae India. 2005;55:436.

Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002 CA. Cancer J Clin. 2005;55:74-108.

Parkin DM, Bray F, Chapter 2: The burden of HPV related cancers. Vaccine. 2006;24 (suppl.3):S11-25.

Miller AB. Gynecology oncology. Churchill Livingston, London; 1992:543.

Jadranka R. Squamous Intra-epithelial lesion. Arch Oncol. 2001;9(3):165-70.

Coppleson M, Pixely E, Reid B. “Colposcopy” a scientific and practical approach to cervix and health and disease. Thomas CC, 2nd Edition; 1978.

Hudson E. The prevention of cervical cancer: The place of cytological smear test. Clin Obstet Gynaecol. 1985;12:33-51.

Ahmedin J, Siegel R, Elizabeth W, Taylor M, Jiaquan X, Carol S. Cancer statistics. Cancer J Clin. 2006;56:106-30.

Algotar K, Nalawade A, Sachdev S. Predictive value of colposcopy in cervical cancer screening. Bombay Hospital J. 2004:4603.

Berek JS. Cervical and vaginal cancer. Berek and Novaks gynecology, 15th Ed. New York, NY: Lippincott Wiliams and Wilkins; 2012:2262-2264.

Arora R, Vijaya K, Habeebullah S, Oumachigui A. Colposcopic evaluation of unhealthy cervix. J Obstet Gynaecol India. 2000;50:102-3.

Lawley TB, Lee RB, Kapela RR. The significance of moderate and severe inflammation on class I Papanicolaou smear. Obstet Gynecol. 1990;76:997.

Handa PR, Dhall GI. Colposcopy as diagnostic aid in cases of suspicious cervix. J Obstet Gynaecol India. 1991;41(6):785-92.

Jones HW. Cervical cancer precursors and their management. Telindes operative gynecology. 9th edition; 2015:1354-1360.

Jammalamadaka A, Manjula J, Baliga BS. Problems and pitfalls of colposcopy in postmenopausal women. J Obstet Gynecol India. 2007;57:525-9.

Massad SL, Collins YC. Strength of correlations between colposcopic impression and biopsy histology. Gynecol Oncol. 2003;89(3):424-8.

Flowers LC, McCall MA. Diagnosis and management of cervical intraepithelial neoplasia. Obstet Gynaecol Clinic North Am. 2001;28(4):667-84.

Achenbach RR, Johnstone RE, Hertig A. The validity of vaginal smear diagnosis in carcinoma in-situ of the cervix. Am J Obstet Gynecol. 1951;61:385.

Sankaranarayanan R, Thara S, Sharma A, Roy C, Shashtri S, Mahe C, et al. Multicentre study group on cervical cancer early detection in India. Accuracy of conventional cytology: results from a multicentre screening study in India. J Med Screen. 2004;11(2):77-84.

Ambiye VR, Shroff C, Allahbadia G, Shanbhag AM, Vaidya PR. Cytology, colposcopy and colposcopically directed biopsy in screening of cervical erosion. J Obstet Gynaecol India. 1989;39:93-6.

Benedet JL, Matisic JP, Bertrand MA. An analysis of 84,244 patients from the British Columbia cytology-colposcopy program. Gynaecol Oncol. 2004;92(1):127-34.

Tamiolakis D, Kalloniatou M, Lambropoulou M, Kambanieris M, Tsopelas A, Daskalakis G, et al. Contribution of combined colposcopy and cytology in cervical pathology. Arch Gynecol Obstet. 2005;273:39-42.

Shiela W, Azhagammai, Kanthamani PN. Histo-cytocolposcopic evaluation of 30 cases of postmenopausal bleeding. J Obstet Gynaecol India. 1991;41:99-102.

Singh V, Das DK, Murthy NS, Luthra UK. Colposcopic observations in precancerous and early cancerous lesions of uterine cervix. J Obstet Gynaecol India. 1989;39:392.

Saraiya UB, Lulla M. Role of colposcopically directed target biopsy in the management of early cervical neoplasia. J Obstet Gynaecol India. 1986;36(4):700-7.

Bharti B. Role of colposcopy in the evaluation of lower female genital tract in 175 symptomatic women. J Obstet Gynaecol India. 2004;5:4.