Does Experience in Colposcopy Improve Identification of High Grade Abnormalities?

Bekkers, Ruud L.M.; Nieuwenhof, H.P. van de; Neesham, Deborah; Hendriks, Jan H. C. L.; Tan, Jeff; Quinn, Michael

doi:10.1097/01.ogx.0000343913.30802.6f

Cited by 15 publications

(22 citation statements)

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“…However, we think that the training before the study was sufficient to have this unfamiliarity resolved. Furthermore, the performance of the colposcopists in this study is similar to that typically reported for colposcopy, 1,[3][4][5][6] indicating that the performance of conventional colposcopy using the DSI colposcope is not hindered by the device itself.…”

Section: Limitationssupporting

confidence: 67%

“…1,[3][4][5][6] The addition of DSI to conventional colposcopy therefore results in an almost 50% increase in sensitivity; from 55% to 79% by DSI colposcopy alone if all preconditions for a optimal examination are met, and to 80% in combination with conventional colposcopy regardless of the circumstances or individual user adequacy. Hence, the higher sensitivity of DSI colposcopy alone or in combination with conventional colposcopy improves the detection of high-grade cervical lesions significantly and guides cervical sampling.…”

Section: Discussionmentioning

confidence: 99%

“…It requires extensive training and experience; however, recent studies have suggested that higher level of experience in colposcopy do not increase sensitivity of conventional colposcopy. 1,2 The variation in the reported performance for colposcopy is high, with the average sensitivity of colposcopy to distinguish low-from high-grade lesions and cancer being around 55%. 1,[3][4][5][6] Furthermore, the low to average sensitivity and specificity of colposcopic examination is also associated with a high degree of inter-and intra-observer variability.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Louwers

Zaal

Kocken

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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Objective To validate the dynamic spectral imaging (DSI) colposcope's colour-coded map in discriminating high-from low-grade cervical lesions and non-neoplastic tissue.Design Prospective, comparative, multicentre clinical trial.Setting The colposcopy clinics of three Dutch hospitals.Population Women of 18 years or over with an intact cervix, referred for colposcopy.Methods During a 3-minute image acquisition phase, the DSI colposcope was used as a regular video colposcope: the colposcopist located and graded potential lesions based on conventional colposcopic criteria. Subsequently, a colour-coded map was calculated and displayed, representing localisation and severity of the cervical lesion. Biopsies were collected from all atypical sites, as identified by digital mapping and/or conventional colposcopy. Furthermore, one additional biopsy was taken. Main outcome measures Histologically confirmed high-grade cervical disease (CIN2+).Results In total 275 women were included in the study: 183 women were analysed in the 'according-to-protocol' (ATP) cohort and 239 women in the 'intention-to-treat' (ITT) cohort. In the ATP cohort, the sensitivity of DSI colposcopy to identify women with high-grade (CIN2+) lesions was 79% (95% CI 70-88) and the sensitivity of conventional colposcopy was 55% (95% CI 44-65) (P = 0.0006, asymptotic McNemar test). When the DSI colour-coded map was combined with conventional colposcopy, the sensitivity was 88% (95% CI 82-95).Conclusions DSI colposcopy has a significantly higher sensitivity to detect cervical lesions than conventional colposcopy. If the colour-coded map is combined with conventional colposcopic examination, the sensitivity increases further.

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Section: Limitationssupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Louwers

Zaal

Kocken

et al. 2010

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

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“…Baum ME, et al and Homesley HD, et al also reported a non-significant difference in agreement and correlation in each year of residency training (Homesley et al, 1985;Baum et al, 2006). Bekkers, et al also concluded in their study that level of experience did not improve colposcopic performance (Bekkers et al, 2008). However, we agreed that a more structured colposcopic training program and re-evaluation system may be more beneficial for the resident and all colposcopists.…”

Section: Discussioncontrasting

confidence: 38%

Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

Tatiyachonwiphut¹,

Jaishuen²,

Sangkarat³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 15 (1), [423][424][425][426] IntroductionCervical cancer is the second most common malignancy in women worldwide after breast cancer (Ferlay et al.). In Thailand, its incidence was 17.7/100,000 of Thai female population during (Khunhaprema et al., 2012. Cervical cancer incidences and deaths have decreased since the implementation of widespread cervical cancer screening with cervical cytology and/or human papilloma virus (HPV) (Saslow et al., 2012). The knowledge of HPV has been advanced. However, the cervical cytology is still the mainstay of cervical cancer screening. Colposcopy is the next investigation step for abnormal cervical screening patients after the followings; a) two consecutive unsatisfactory cytology results; b) most cases of positive HPV testing; c) repeated atypical squamous cell of undetermined significance (ASC-US) cytology; d) low grade squamous intraepithelial lesion (LSIL) cytology; e) atypical squamous cell, cannot exclude high grade squamous intraepithelial lesion (ASC-H) cytology; f) high grade squamous intraepithelial lesion (HSIL) cytology; g) some types of glandular abnormality (Massad et al., 2013

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“…Unfortunately the sensitivity of colposcopy to detect high-grade cervical lesions is low, around 55%. [3][4][5][6] It has previously been shown by us and others that the sensitivity of colposcopy can be significantly improved when the dynamic spectral imaging (DSI) colposcope is used. 7,8 Recently in a sub-study of the ALTS trial (atypical squamous cells of undetermined significance [ASCUS]-lowgrade squamous intraepithelial lesion [LSIL] Triage Study) 9 Jeronimo et al 10 observed that HPV16 positive (HPV16 + ) lesions produce more defined visual abnormalities at colposcopy than lesions caused by other hrHPV types, regardless of final histological diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Agreement between colposcopic impression and histological diagnosis among human papillomavirus type 16‐positive women: a clinical trial using dynamic spectral imaging colposcopy

Zaal

Louwers

Berkhof

et al. 2012

BJOG

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Objective To investigate the agreement between conventional colposcopic impression, dynamic spectral imaging (DSI) colposcopy and histology, for human papillomavirus type 16-positive (HPV16 + ) and non-16 high-risk (hr) HPV + women.Design Prospective, comparative, multicentre clinical trial.Setting Three colposcopy clinics in the Netherlands.Population Women (n = 177) aged 18 years or over with an intact cervix, referred for colposcopy.Methods The colposcopist graded the lesion by using the DSI colposcope as a regular video colposcope. Subsequently the DSI impression was displayed and biopsies were taken from all abnormal areas as well as from a random (normal) site. A cervical smear was taken for HPV typing.

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Does Experience in Colposcopy Improve Identification of High Grade Abnormalities?

Cited by 15 publications

References 0 publications

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Dynamic spectral imaging colposcopy: higher sensitivity for detection of premalignant cervical lesions

Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

Agreement between colposcopic impression and histological diagnosis among human papillomavirus type 16‐positive women: a clinical trial using dynamic spectral imaging colposcopy

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