Importance of Colposcopy for screening of Premalignant Lesions of Cervix: An Experience of Tertiary Public Health Hospital in India
Vinita Sarbhai, Mohini Paul, Sangita N Ajmani
Citation Information :
Sarbhai V, Paul M, Ajmani SN. Importance of Colposcopy for screening of Premalignant Lesions of Cervix: An Experience of Tertiary Public Health Hospital in India. Int J Gynecol Endsc 2017; 1 (2):65-68.
Aim: The aim of this article is to correlate the clinical, cytological, and colposcopic findings for detection of premalignant lesions of cervix.
Materials and methods: A total of 100 nonpregnant females attending the gynecology outpatient department (OPD) in Kasturba Hospital, New Delhi, India, were enrolled in the study. Papanicolaou (Pap) smear was done in first OPD visit. Colposcopy was done in these patients and patients with satisfactory colposcopy were subjected to biopsy if any abnormal finding was detected; in those with unsatisfactory colposcopy, endocervical curettage and conization were done. Samples were sent for histopathology examination and findings were correlated.
Results: The Pap smear was evaluated according to Bethesda system, which showed 70 patients had inflammatory smear, 6 had inflammatory with definitive organism, and 14 were abnormal. Out of 14 abnormal smears, 5 cases of atypical squamous cells of uncertain significance (ASCUS), 8 cases of low-grade squamous intraepithelial lesion (LSIL), and 1 case of squamous cell carcinoma (SCC) were noted. Sensitivity of Pap smear for detecting all grades of cervical intraepithelial neoplasia (CIN) was found to be 50%.
On colposcopy, 30% had normal appearance and 38% had miscellaneous findings; 28 patients with abnormal colposcopy finding were graded according to Reid\'s colposcopy index, and findings showed 26 abnormal and 2 suspected of invasive cancer. Biopsy was done in 32 patients, including abnormal and unsatisfactory colposcopy.
Sensitivity of colposcopy for detecting all grades of CIN and SCC was found to be 92.85%. After combining both Pap smear and colposcopy, detection rate was 100%.
Conclusion: Colposcopy and Pap smear should be done together for early detection of premalignant cervical intraepithelial lesions to reduce the burden of cervical cancer and its associated morbidity and mortality.
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