Correlation of Pap Smear and Colposcopic Findings in Relation to Histopathology in Detection of Premalignant Lesions of Cervix
Keywords:Cervical Cancer, Cervical Biopsy, Pap smear, Colposcopy, Unhealthy cervix
Background: Cancer develops from the premalignant lesions (CIN) over a period of time which can be diagnosed by screening tests. The Papanicolaou (Pap) smear was the initial screening test for CIN and invasive cervical cancer. However, the simultaneous use of Pap smear and colposcopy has been shown to increase the rate of the cervical cancer detection. So this study was done to assess the reliability of colposcopy by correlating the findings of colposcopy with cytology and colposcopic directed biopsy in women with unhealthy cervix .
Materials and Method: This was a prospective observational study conducted in 100 women aged between 18 to 65 years with unhealthy cervix. All were subjected to screening by Pap smear, colposcopy and colposcopic guided biopsy and their results were compared and correlated. Final correlation of the Pap smear and colposcopy were based on histopathology results.
Results: In the present study, the sensitivity of Cervical colposcopy was more than Pap smear (90.3% Vs 67.25%) but its specificity was only 64.9% compared to 97.7% of the Pap smear. This study demonstrated a high correlation between colposcopy and histology of 94.84%. The correlation between Pap smear and colposcopy was 99 %. The correlation between Pap smear and histology was 82%.
Conclusion: Colposcopy and colposcopic directed biopsy should be included along with Pap smear in screening for early detection of cancer of cervix since the accuracy of detection of cervical abnormalities is higher when they are used complementarily.