Comparison of Pap Smear and Colposcopy in Screening for Cervical Cancer in Patients with Secondary Immunodeficiency

Abstract

IntroductionCervical cancer is the second most common cancer among women worldwide. The sensitivity of conventional Pap smear in detecting cervical lesions before cervical cancer is 51%, which means the false negative value is 49%. The aim of this study was to compare two methods for screening for cervical cancer in patients with secondary immunodeficiency, i.e., the conventional Pap smear and colposcopy.MethodsThis cross-sectional study was conducted on 101 immunodeficient patients who were referred to the Gynecologic Clinic at Shahid Sadughi Hospital in Yazd from March 2011 to August 2012. All patients underwent the Pap test, a colposcopy, and a cervical biopsy, with the latter being considered as the gold-standard test.ResultsThe most frequency of immunodeficiency was noted among patients with rheumatoid arthritis (53.3%), and this was followed by patients who were undergoing chemotherapy (30.7%), patients with lupus erythematosus (12.9%), and patients with AIDS (3%). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the Pap smear were 18.2, 98.5, 85.5, 71.3, and 72.2%, respectively. The respective values for colposcopy were 66.7, 98.94, 80, 97.9, and 97%, respectively.ConclusionIn this study the accuracy, sensitivity, specificity, and negative predictive values of colposcopy were higher than those for the Pap smear in detecting high-grade, cervical, pre-malignant lesions (cervical intraepithelial neoplasia: CIN ≥ 2). Therefore, an annual colposcopy is advised for secondary immunodeficient patients instead of a Pap smear.

Cervical Cancer Screening with Visual Inspection with Acetic Acid and Lugol as Primary Screening Test, a Comparable Result to Conventional PAP Smear in Northern Cameroon

“…In this study we evaluated how PAP Smear test, VIA and VILI could be used as screening methods in Nord west of Cameroon. The gold standard test for cervical cancer screening is indeed colposcopy, it has been used to demonstrated limit of the PAP Smear in terms of accuracy, sensitivity, specificity, and negative predictive values in detecting highgrade, cervical, pre-malignant lesions [18]. But in the context of our study, we were unable to get access to this test.…”

Significance of Pap Smear in Detecting Abnormalities of Cervix in Hiv-Infected Women

“…[11] Mojgan et al (2015) observed that 20.3% of HIV patients had abnormal Pap smears and 10.7% of them had abnormal colposcopy. [12] It was observed that the maximum incidence of epithelial abnormalities was between the age group of 31-40 years. Both the patients with squamous cell carcinoma were under the age of 40 years.…”

Comparative analyses of PAP smear data in pre and post menopause Indian women

“…Though conventional PAP smear was used in this study, various studies have demonstrated significant relationship between conventional PAP smear, Liquid based cytology (LBC) and Colposcopy method. Karimi-zarchi et al has compared the results of conventional PAP smear, Liquid based cytology and Colposcopy method and found that Colposcopy with sensitivity of 70.9% can be stated to be superior than LBC PAP with sensitivity of 55.3% and in the comparison of compliance of the conventional PAP smear with that of the LBC, no significant relationship was found [ 13 ]. Thus, general colposcopy method has a higher sensitivity in diagnosis of any cervical lesions compared to the conventional PAP smear and liquid-based PAP smear.…”