Diagnostic Value of Pap Smear and Colposcopy in Non-benign Cervical Lesions

Abstract

Objectives: Cervical cancer is a very common and lethal condition; however, owing to longstanding premalignant lesions, it is possible to prevent morbidity and mortality by screening tests. Pap smear, colposcopy, and biopsy are among the main modalities in this regard, however there is no consensus on the diagnostic utility of the first 2 methods. This study sought to examine the diagnostic utility of Pap smear, colposcopy, and cytology in evaluating the non-benign cervical lesions. Materials and Methods: A cross-sectional study was carried out between 2014 and 2016 in an out-patient setting at Alzahra teaching hospital of Tabriz University of Medical Sciences. After obtaining informed consent, all 315 participants with abnormal Pap test underwent colposcopy and biopsy from the abnormal areas. Cervical biopsy was considered as a gold standard and the diagnostic values of Pap smear and colposcopy were individually compared by calculating sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratio. Results: The mean age of patients was 38.49±10.31 years (17-68 years). On the basis of biopsy findings, non-benign cervical lesions were present in 31 cases (9.8%). Accordingly, the sensitivity, specificity, positive predictive value, negative predictive value, and positive likelihood ratio of Pap smear in revealing non-benign cervical lesions were 77.4%, 69.7%, 21.8%, 95.6%, 70.7%, and 2.55%, and for colposcopy, were 90.3%, 90.9%, 51.9%, 98.9%, 90.8%, and 99.2%, respectively. Conclusions: Based on our results, the colposcopy is a sensitive and specific method in differentiating benign cervical lesions from non-benign cervical lesions. The accuracy of Pap smear is intermediate in this regard, and the utility is limited. Therefore, this method should not be considered as the main criterion for decision making.

Prevalence of High-Risk Human Papillomavirus Types Among Women Screened for Cervical Cancer in Yazd, Iran, and Comparison of Cytology, Histology, and Colposcopy Results

“…Incompatible with the findings of the present study, several studies have reported that the sensitivity of colposcopy is higher than that of Pap test for the detection of high-grade cervical lesions (1,22,24). In a study conducted in Yazd, Iran, the sensitivity of Pap smear and colposcopy was 50% and 80%, respectively, which is in contrast to our results (25).…”

“…Cervical cancer is the fourth most frequent malignancy that affects women. The World Health Organization (WHO) estimates that 530,000 new cases of cervical cancer are diagnosed worldwide that lead to 275,000 death each year (1). Approximately 90% of deaths are reported from lowand middle-income countries.…”

HPV molecular detection from urine versus cervical samples: an alternative for HPV screening in indigenous populations

“…Clinical diagnosis is focused on the cellular morphological changes caused by HPV infection. The Papanicolaou test is considered the gold standard for early detection of cervical carcinoma, however, the Pap test results should not be considered to be a determinant criterion in the treatment decision (Sayyah-Melli et al, 2019;Kitchen & Cox, 2020). It is highly recommended that the cytological diagnosis via the Pap test be complemented with molecular HPV detection to increase the certainty of the diagnosis and maximize cancer prevention.…”