Combined use of cytological, visual and colposcopic examination for evaluation of unhealthy cervix and their histopathological correlation

Abstract

Background: Unhealthy cervix can be a presentation of a broad spectrum of clinical conditions with diverse pathologies like infective, inflammatory, reactive and neoplastic etc. Cervical cancer, having a multifactorial causation, is the second most common cancer in female population. Because of a prolonged preinvasive phase, the cancer can be diagnosed at an earlier stage. Early diagnosis makes it amenable to treatment.Methods: A total 100 ladies attending gynaecology OPD of a tertiary care teaching hospital with unhealthy cervix were evaluated. It involved history taking, cytological assessment by Pap smear, examination of cervix after acetic acid application (VIA), colposcopic assessment and biopsy for histopathological evaluation.Results: Correlation of all these modalities to rule out neoplastic aetiology showed a high specificity of 91.9%. The positive predictive value of combined approach was found to be 65% whereas negative predictive value approached 100%.Conclusions: Combined approach with VIA, Colposcopy, Pap smear and Directed biopsy provide a comprehensive evaluation of unhealthy cervix.