Is it necessary to repeat cervical cytology at the tie of a colposcopy?

Abstract

OBJECTIVES: to evaluate whether repeating Papanicolaou smear testing at the time of colposcopy improves agreement between cytology and histopathology in the diagnosis of cervical cancer. METHODS: this cross-sectional study included 397 women referred for colposcopic evaluation following an abnormal cervical smear test. The cytology was repeated at the time of the colposcopy using a conventional medium. The two cytology tests were compared with each other and with the histopathological findings obtained by colposcopy-directed biopsy. The 2001 Bethesda system and the WHO 1994 classification were used for reporting cytology and histology results. The kappa coefficient was used to determine the agreement between methods. RESULTS: the comparison between the initial cytology findings and cytology performed at the time of colposcopy revealed a kappa of 0.297 (95%CI: 0.235-0.359), indicating a fair degree of agreement. When the results of the initial cytology were compared with histopathology, a kappa of 0.261, considered to represent a fair degree of agreement, was obtained (95%CI: 0.181-0.340). A kappa of 0.408, considered to represent moderate agreement, was found when the second cytology findings were compared with the histopathology (95%CI: 0.332-0.485). CONCLUSIONS: the agreement between cytology and histology improved when cytology was repeated at the time of colposcopy, following an initial abnormal test.

Evaluation of Pap Smear And HPV VLP Serology in Clinically Suspected Cases Of Cervical Cancer in Perimenopausal Women in A Tertiary Care Centrein Kolkata

“…[18] The prevalence of CIN1 in the present study is the same as above. However, the prevalence of CIN2 and CIN3 were much higher than the present study.…”

“…However, the prevalence of CIN2 and CIN3 were much higher than the present study. This may be due to the larger sample size of 334 women [18] as compared to 90 women in our study. Secondly, the women in the above study underwent colposcopic directed biopsy which may also increase the sensitivity of histopathology.…”

“…[20] However, Katz et al in 2012 found the kappa value for conventional cervical cytology screening as 0.261, representing fair agreement. [18] This may be due to interpretation error or sampling error. Further there was only one reactive sample, so no association between HPV serology and cervical dysplasia/cancer could be obtained.…”