Diagnostic Accuracy of Cervical Pap Smear and Colposcopy in Detecting Premalignant and Malignant Lesions of Cervix
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ORIGINAL ARTICLE
Diagnostic Accuracy of Cervical Pap Smear and Colposcopy in Detecting Premalignant and Malignant Lesions of Cervix Fatemeh sadat Najib 1 & Masooumeh Hashemi 2 & Zahra Shiravani 1 & Tahereh Poordast 1 Elham Askary 1
&
Sanam Sharifi 3 &
Received: 19 October 2019 / Accepted: 1 June 2020 # Indian Association of Surgical Oncology 2020
Abstract The objective of this study was to determine the diagnostic accuracy of pap smear and colposcopy in detecting the premalignant and malignant lesion of the cervix. In this cross-sectional study, a total number of 160 women who presented with abnormal clinical problem or routine checkup during a 6-month period were included. All the patients underwent pap smear and colposcopy by the same gynecologists team, and finally, cervical biopsy was performed in all the individuals. The demographic and clinical characteristics as well as the obstetrics history were recorded. The diagnostic accuracy of each test was calculated according to the biopsy as gold standard. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were recorded and compared between two modalities. Overall, we included a total number of 160 patients with mean age of 37.6 ± 7.32 (ranging from 24 to 63) years. The sensitivity and specificity of pap smear were found to be 47.19% and 64.79%, respectively. The PPV and NPV of the pap smear were calculated to be 88.69% and 38.46%, respectively. The sensitivity and specificity, PPV, and NPV of the colposcopy were calculated as 64.72%, 52.74%, 76.32%, and 95.41%, respectively. The overall diagnostic accuracy of the pap smear and colposcopy was reported to be 82.2% and 96.3%, respectively. The results of this study demonstrate that colposcopy has a higher diagnostic accuracy in detecting cervical premalignant and malignant lesions compared to the pap smear. Keywords Colposcopy . Pap smear . Pathology . Cervix . Premalignant lesions
Introduction Cancer of the cervix is considered the second mostly diagnosed cancer in women. According to the 2018 global statistics, 569,847 new cases are diagnosed annually of whom 311,365 die due to the cancer itself [1]. The incidence and mortality are increasing worldwide gradually which is associated with increased social and economic burden along with years of life lost [2]. The cervical cancer most important risk
* Tahereh Poordast [email protected] 1
Infertility Research Center, Obstetrics and Gynecology Department, Division of Oncology Gynecology, Shiraz University of Medical Sciences, OB & GYN ward, Faghihi Hospital, Zand Blvd, Shiraz, Iran
2
Fellowship of Oncology Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
3
Shiraz University of Medical Sciences, Shiraz, Iran
factors has been reported to be the human papilloma virus (HPV) infection which is a very common infection in sexually active women [3, 4]. The cervical cancer can be prevented or diagnosed in early stages via the routine and structured screening programs of the cervical cytology [5, 6].
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