Diagnostic Role of Portable Colposcope (Gynocular) for Diagnosis of Pre-Invasive Lesions of Cervix
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ORIGINAL ARTICLE
Diagnostic Role of Portable Colposcope (Gynocular) for Diagnosis of Pre-Invasive Lesions of Cervix Nisha Singh1 • Neha Negi1 • Sonali Sharma1 • Tuhina Singh2 Received: 30 March 2020 / Revised: 22 May 2020 / Accepted: 26 May 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Introduction Colposcopy-guided biopsy is the standard method to diagnose cervical pre-invasive lesions. However, standard colposcopes are expensive, require lot of space and depend on electricity for its use. A mobile version of colposcope (Gynocular) has been recently introduced which overcomes such issues. We conducted this study to evaluate the diagnostic accuracy of Gynocular for cervical intraepithelial lesions. Materials and Methods This cross sectional study was conducted over one year in a tertiary care referral centre in North India. Total 222 women with abnormal Pap smear were included. To avoid observer bias, Gynocular and standard colposcope examinations were performed by two different observers at different places. Patients with swede score 5 or above by standard colposcopy were subjected to biopsy. Kappa statistics was applied for analysing correlation of swede score by the two methods and diagnostic efficacies were calculated with histopathology as gold standard. Results 100 women had swede score of 5 or above with Gynocular and 86 of these had high swede score on colposcopy also. Histopathology was available for these 86 women. Both colposcopy methods were in strong agreement (Kappa = 0.795; p \ 0.001) for swede scoring. HPE showed CIN 1 in 13.95%, CIN 2 in 4.65%, CIN3 in 6.98% and invasive cancer in 13.95% women. The HPE based sensitivity, specificity, negative and positive predictive values for Gynocular(100%, 61%, 100% and 22% respectively) were comparable with Standard colposcope. Conclusions Gynocular has comparable diagnostic accuracy with standard colposcope in diagnosing CIN. Keywords Cervical cancer screening Colposcopy Swede score Cervical cancer prevention Community health
Introduction Cervical cancer has very high mortality and morbidity. It is the second-most common cancer affecting Indian women, the first being breast cancer. Among the preventive strategies, HPV (Human Papilloma virus) vaccination is available for primary prevention while screening and treatment of pre-invasive lesions is the mainstay for secondary prevention. HPV vaccination, though available since almost a decade, is not affordable by majority of our population. Screening followed by treatment of pre-
& Nisha Singh [email protected] 1
Department of Obstetrics and Gynecology, King George Medical University, Lucknow, UP 226003, India
2
Government Medical College Kannauj, Kannauj, India
invasive lesions is still the best approach for reducing the disease burden in our country. It is recommended to continue screening in the vaccinated population too. Cytology was the only method for screening since the discovery of Pap stain in the 1940s. It is currently replaced by Liquid-Based Cytology at most pl
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