A study to evaluate the performance of colposcopy and conventional cytology in VIA positive women

Abstract

Background: Cervical cancer is preventable in pre-invasive state when effective programmes are implemented to detect and treat its precursor lesions. Cervical cancer is the most common cancer among Indian women. The present study evaluates the performance of colposcopy vs conventional cytology in estimating the presence and grade of cervical disease against the reference standard of histopathology as a secondary test modality to triage women found positive on primary screening by visual inspection with 5% acetic acid (VIA). Methods: This was a prospective observational study. 50 women of of reproductive age who were found VIA positive were subjected to Pap smear and colposcopy, whereas histopathology was done in patients having abnormal findings on colposcopy. Biopsies were taken from the abnormal areas. Data were entered in the institution using standard computer software. Diagnostic accuracy for single test was calculated using 2*2 tables and standard formulae. Results: The diagnostic accuracy of Pap smear was found to be 77% and that of Colposcopy was 87%. The accuracy of colposcopy was higher than that of Pap smear. Conclusion: It is very important to diagnose the CIN lesions with accuracy once a woman comes to a tertiary care hospital with symptoms or is referred for a suspicious looking cervix. All these women must be screened by colposcopy and directed biopsy must be taken if indicated in the same sitting.