Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions

Abstract

Background: The purpose of this research is to estimate the rate of concordance, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy for high-grade squamous lesions and carcinomas (HSIL+). Methods: We conducted a retrospective study of colposcopies performed in the certified Dysplasia Unit in Erlangen between January 2015 and May 2022 (7.5 years). The colposcopic findings were correlated with biopsies obtained during examinations or surgery. Cases without histology were excluded. The primary outcome was the rate of concordance between the colposcopic and histological findings in relation to the type of transformation zone (TZ), examiner’s level of experience and age of the patients. Results: A total of 4778 colposcopies in 4001 women were analyzed. The rates of concordance for CIN I/LSIL, CIN II/HSIL, CIN III/HSIL, and carcinoma were 43.4%, 59.5%, 78.5%, and 53.9%, respectively. The rate of concordance was lowest for TZ3 and highest for colposcopists with more than 10 years’ experience. Conclusions: Colposcopy is an important, feasible, and effective method. Careful work-up needs to be performed for women with TZ3 who are over 35 years old, as they are at the highest risk of being misdiagnosed. The highest concordance for detecting HSIL+ was seen for colposcopists with >10 years’ experience.

Burden of CIN2+ diagnoses and conizations in women aged 18–45 years—a retrospective secondary data analysis of German statutory health insurance claims data

“…In Europe, about 45% of CIN2+ and 70% of cervical cancers are attributable to HPV genotypes 16 and 18 and more than 80% of CIN2+ and 90% of cervical cancers to genotypes 16,18,31,33,45,52, 58 [9]. A recent German study evaluated the distribution of high-risk HPV types in women with CIN and cervical cancer [10]. HPV genotypes 16 or 18 were detectable in 40% of CIN3 lesions and 79% of cervical cancers.…”

Development and validation of artificial intelligence-based analysis software to support screening system of cervical intraepithelial neoplasia

“…LSIL usually occurs as a change in the cervix due to a transient infection with HPV and often regresses spontaneously 32 . The sensitivity of clinician performed colposcopy to detect HSIL is not known to be higher than 80% according to previous studies 18 , 33 . CerviCARE AI, which we used in this study, has a sensitivity and specificity of more than 95.0%, although we used carefully selected images.…”

Evaluation of the diagnostic performance of colposcopy in the detection of cervical high-grade squamous intraepithelial lesions among women with transformation zone type 3

“…However, senior colposcopists had lower specificity (71.07% versus 76.72%) and almost comparable accuracy (72.60% versus 72.55%). In a similar study done in Germany, the colposcopic sensitivity (86.0% versus 70.2%) of senior colposcopists to diagnose CIN2 + lesions was higher than junior colposcopists, with lower specificity (65.1% versus 68.6%) [ 31 ]. One possible explanation might be the fact that young colposcopists lack of course and some amount of knowledge and skills acquired over the years.…”