Pap smear accuracy for the diagnosis of cervical precancerous lesions

Nkwabong, Elie; Badjan, Ingrid Laure Bessi; Sando, Zacharie

doi:10.1177/0049475518798532

Cited by 36 publications

(31 citation statements)

References 13 publications

(23 reference statements)

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“…Unlike our findings were patients' age was associated with the accuracy of cytology, previous studies have demonstrated the accuracy of Pap smear in diagnosing cervical intraepithelial lesions by comparing the characteristics of cervical dysplasia versus non-dysplasia. 13 Age, smoking, number of abortions, age at first delivery, and number of sexual partners were not significantly different across both groups. HPV infection is the most important factor, though the genotypes were not investigated.…”

Section: Discussionmentioning

confidence: 81%

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Discrepancy between Cytology and Histology in Cervical Cancer Screening: a Multicenter Retrospective Study (KGOG 1040)

et al. 2021

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Background Cervical cancer is the fourth common cancer in women worldwide. The Papanicolau test is the primary screening procedure to detect abnormal cervical cells. Colposcopy is the main procedure for discriminating high-grade cervical lesions. The study aimed at clarifying the discrepancy between cervical cytology and colposcopic biopsy histology as well as confounding factors. Methods Eligible patients visited thirteen tertiary hospitals for colposcopic biopsy following cervical cytology and human papillomavirus (HPV) genotypes between January and December 2018. Baseline characteristics including age, body mass index (BMI), and parity were collected. Results In our study, 3,798 eligible patients were included. Mean age of patients was 42.7 (19–88) years and mean BMI was 22.5 (16.9–34.1) kg/m 2 . The referred cervical cytologic findings consisted of 495 normal, 1,390 atypical squamous cells of undetermined significance, 380 atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion, 792 low-grade squamous intraepithelial lesion, 593 high-grade squamous intraepithelial lesion, 79 atypical glandular cells, 46 squamous cell carcinoma, and 23 adenocarcinoma. HPV-positive findings were found in 3,008 (79.2%) patients and were not detected in 914 (24.1%) cases. The risk of unexpected low-grade lesions from histology was higher in patients > 45 years (odds ratio [OR], 2.137; 95% confidence intervals [CIs], 1.475–3.096). In contrast, the risk of unexpected high-grade lesions from colposcopic biopsy was lower in patients ≥ 45 years (OR, 0.530; 95% CI, 0.367–0.747) and HPV 16/18 infection was higher than other HPV (OR, 1.848; 95% CI, 1.385–2.469). Conclusion Age and HPV genotypes were responsible for the discrepancies between cytology and histology. Precautions should be taken for women over the age of 45 in triage for colposcopy in order to avoid unnecessary testing.

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Section: Discussionmentioning

confidence: 81%

“…However, the accuracy and reproducibility of cervical cytology are limited. 13 Cytology diagnosis accuracy mainly depends on the pathologists' experience and the characteristics of patients. 25 Recently, several studies show that a reduction in unnecessary colposcopy and induce objective cytology results.…”

Section: Discussionmentioning

confidence: 99%

Discrepancy between Cytology and Histology in Cervical Cancer Screening: a Multicenter Retrospective Study (KGOG 1040)

et al. 2021

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“…The sensitivity of this investigative modality remains low in numerous studies including ours. 6,7 This mandates that it needs to be augmented with other tests to make early detection of cervical cancer more certain. Because of this, there has been criticism of reliability of annual Pap smear.…”

Section: Discussionmentioning

confidence: 99%

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

Patil

Pathak

2021

Int J Reprod Contracept Obstet Gynecol

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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.

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“…(11) According to the descriptive study conducted by Nkwabong et al the concluding remark is that cervical biopsy is mandatory if it has abnormal architecture. (13) According to the approved guidelines, LLETZ is performed preferably under local anesthesia in an outpatient department and doesn't require a hospital stay. Due to lack of availability of sources and skilled personnel in our outpatient department, the procedure was conducted under general anesthesia in all the patients.…”

Section: Discussionmentioning

confidence: 99%

Diagnosing Cervical Lesions Through LLETZ – A Reliable and Effective Tool

Wasim¹,

Arif²,

Ameer³

et al. 2020

Int J Front Sci

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Background: Cervical dysplasia is the most common gynecological disorder of modern era. It initiates around the squamocolumnar junction of the cervix commonly due to the infection of human papilloma virus. Large loop excision of transitional zone is globally a standard procedure of choice both for diagnosing and treating cervical dysplasia. Pap smear is a fast and easy assessment tool for detecting cervical lesions, but it is relatively unreliable. Methodology: Fifty patients of age group 35 to 65 years patients having normal looking cervix with abnormal pap smear or suspicious looking cervix with or without abnormal pap smear, were selected for the study after informed consent. The procedure for LLTEZ was performed under strict aseptic measures in the procedural room and the biopsy specimen was sent for histopathological examination. The pathological findings were presented as percentages. Results: 66% cervical biopsy specimens were suggestive of chronic cervicitis and 24% samples were suggestive of chronic cervicitis with squamous metaplasia. Mild dysplasia in 4% samples, moderate and severe dysplasia were seen in 2% samples. Conclusion: LLETZ is an efficient procedure to deal with cervical dysplasia. It must be recommended for the work-up of uncertain gynecological presentations. The expertise of professionals must be improved through training to obtain maximum benefits.

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Pap smear accuracy for the diagnosis of cervical precancerous lesions

Cited by 36 publications

References 13 publications

Discrepancy between Cytology and Histology in Cervical Cancer Screening: a Multicenter Retrospective Study (KGOG 1040)

Discrepancy between Cytology and Histology in Cervical Cancer Screening: a Multicenter Retrospective Study (KGOG 1040)

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

Diagnosing Cervical Lesions Through LLETZ – A Reliable and Effective Tool

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