Study of accuracy of colposcopy in VIA and HPV detection‐based cervical cancer screening program

Ghosh, Ishita; Mittal, Srabani; Banerjee, Dipanwita; Singh, Priyanka; Dasgupta, S; Chatterjee, Simi; Biswas, Jaydip; Panda, Chinmay Kumar; Basu, Partha

doi:10.1111/ajo.12282

Cited by 38 publications

(40 citation statements)

References 20 publications

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“…The failure to detect HSIL from colposcopy in the present study corresponded to a recent study from India (Ghosh et al, 2014). The Indian noted a very poor agreement with kappa only 0.17 between the colposcopic finding and the final histology of colposcopy in an HPV detection-based cervical cancer program of over 2000 women.…”

Section: Discussionsupporting

confidence: 55%

Histologic Outcomes in HPV-Positive and Cervical Cytology-Negative Women - Screening Results in Northern Thailand

Vijakururote

Suprasert²,

Srisomboon³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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The objective of this study was to determine the prevalence of significant lesions defined as high grade squamous intraepithelial lesions (HSIL), adenocarcinoma in situ (AIS) and invasive carcinoma in women who had HPV-positive and cytology negative co-testing screening results. This retrospective study was conducted in Chiang Mai University Hospital between May, 2013 and August, 2014. Hybrid capture 2 (HC2) was used for HPV testing and conventional Pap smears for cytologic screening. A repeat liquid-based cytology (LBC) was performed in women with such co-testing results followed by colposcopy. Random biopsy was performed in cases of normal colposcopic findings. Further investigations were carried out according to the biopsy or the repeat LBC results. During the study period, 273 women met the criteria and participated in the study. The mean age of these women was 46.4 years with 30% of them reporting more than one partner. The median interval time to colposcopy was 165 days. About 40% showed an abnormality in the repeat cytology. Significant cervical lesions were found in 20 (7.3%) women, including 2 invasive cancers. Of interest was that only 2 of 20 significant lesions were diagnosed by colposcopic examination while the remainder were initially detected by cervical biopsy and abnormal repeat cytology. In conclusion, the prevalence of significant cervical lesions in HPV positive and cytology negative women in Northern Thailand was 7.3%. Further diagnostic work up with repeat cytology follow by colposcopy is recommended. Random biopsy should be performed even when the colposcopic findings are normal.

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Section: Discussionsupporting

confidence: 55%

Histologic Outcomes in HPV-Positive and Cervical Cytology-Negative Women - Screening Results in Northern Thailand

Vijakururote

Suprasert²,

Srisomboon³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…A few studies have reported the colposcopic accuracy of the IFCPC classification. The colposcopic sensitivity, specificity, PPV, and NPV for HSIL were reported to be 61.1%, 94.4%, 43.1%, and 77.9% in Hammes et al's study in 2007 when the 2002 nomenclature was used [14] and 84.8%, 66.1%, 10.3%, and 98.9% in Ghosh et al's study in 2014 when the 2011 nomenclature was used [16]. Our results with the 2011 nomenclature were appreciably better than the former study and showed lower sensitivity, higher specificity, much higher PPV, and equal NPV compared with the latter.…”

Section: Discussionmentioning

confidence: 99%

“…The accuracy of the preceding 2002 nomenclature diagnosis and its reproducibility have been analyzed in some reports and good results were obtained [14, 15]. However, as for the applicability of the 2011 IFCPC terminology, evaluation studies are extremely scant [16, 17]. …”

Section: Introductionmentioning

confidence: 99%

Closer to a Uniform Language in Colposcopy: Study on the Potential Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology in Clinical Practice

Duan

Sui

et al. 2017

BioMed Research International

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As the newest colposcopic terminology, the 2011 International Federation for Cervical Pathology and Colposcopy (IFCPC) classification provides standardized interpretation of colposcopic findings. In this study, we analyzed the colposcopic accuracy and the significance of individual findings according to the 2011 IFCPC classification in 525 patients, reviewed by 13 trained colposcopists. Results show that colposcopic diagnoses are in 64.95% perfect agreement with cervical pathology, with 63.64% sensitivity and 96.01% specificity for high-grade squamous intraepithelial lesion (HSIL+). And the accuracy is reproducible across different experienced examiners. Many individual findings, especially the two new signs, inner border sign and ridge sign, are proved to have good predictive accuracy, while iodine negativity demonstrates an inferior performance. However, the distribution of three cervical transformation zone (TZ) types is heterogeneous in examiners. A comparison was also made of the findings of another two colposcopists without nomenclature training according to the Reid Colposcopic Index (RCI), modified RCI, and Swede Score. Results show that colposcopic accuracies in them are lower than in those nomenclature trained colposcopists. The 2011 IFCPC nomenclature improves colposcopic accuracy in trained colposcopists, like speaking the same language. However, the reproducibility of TZ and the predictive value of a few signs remain to be discussed.

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“…Physician interpretation of colposcopy images (with both devices) agreed less frequently with histopathologic assessment than with each other. Previous studies have also demonstrated poor agreement between colposcopy and histopathology 18,19,20 .…”

Section: Discussionmentioning

confidence: 91%

International Image Concordance Study to Compare a Point-of-Care Tampon Colposcope With a Standard-of-Care Colposcope

Mueller

Asma

Lam

et al. 2017

J Low Genit Tract Dis

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Objective Barriers to cervical cancer screening in low resource settings include lack of accessible high quality services, high cost, and the need for multiple visits. To address these challenges, we developed a low cost intra-vaginal optical cervical imaging device, the Point of Care Tampon (POCkeT) colposcope, and evaluated whether its performance is comparable to a standard-of-care colposcope. Methods There were two protocols, which included 44 and 18 patients respectively. For the first protocol, white light cervical images were collected in vivo, blinded by device, and sent electronically to 8 physicians from high, middle and low income countries. For the second protocol, green light images were also collected and sent electronically to the highest performing physician from the first protocol who has experience in both a high and low income country. For each image, physicians completed a survey assessing cervix characteristics and severity of precancerous lesions. Corresponding pathology was obtained for all image pairs. Results For the first protocol, average percent agreement between devices was 70% across all physicians. POCkeT and standard-of-care colposcope images had 37% and 51% percent agreement respectively with pathology for high-grade squamous intraepithelial lesions (HSILs). Investigation of HSIL POCkeT images revealed decreased visibility of vascularization and lack of contrast in lesion margins. After changes were made for the second protocol, the two devices achieved similar agreement to pathology for HSIL lesions (55%). Conclusions Based on the exploratory study, physician interpretation of cervix images acquired using a portable, low cost, POCkeT colposcope was comparable to a standard-of-care colposcope.

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Study of accuracy of colposcopy in VIA and HPV detection‐based cervical cancer screening program

Abstract: Colposcopy performed well in the overall detection of cervical neoplasias, though its capability for accurate categorisation of degree of abnormality was poor.

Cited by 38 publications

References 20 publications

Histologic Outcomes in HPV-Positive and Cervical Cytology-Negative Women - Screening Results in Northern Thailand

Histologic Outcomes in HPV-Positive and Cervical Cytology-Negative Women - Screening Results in Northern Thailand

Closer to a Uniform Language in Colposcopy: Study on the Potential Application of 2011 International Federation for Cervical Pathology and Colposcopy Terminology in Clinical Practice

International Image Concordance Study to Compare a Point-of-Care Tampon Colposcope With a Standard-of-Care Colposcope

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