CERVICAL DISEASES

Abstract

Objectives: The aim of our study is to compare the efficacies of Pap smearcytology, colposcopy and histopathology, in diagnosis of cervical diseases. Study Design:Cross sectional cohort study. Period: One year from June 2013 to June 2014. Setting:Tertiary care hospital in Karachi, Pakistan. Method: The patient population n=145 consistedof women ranging from age 18 to 80 years old, who had come to the outpatient clinics for avariety of symptoms. Pap smear, colposcopy and histopathology was done for women who hadsymptoms like recurrent vaginal discharge, postcoital bleeding and other diseases of the cervix.Findings were noted on a proforma and all the patients signed a duly informed consent. Datawas analyzed using SPSS version 23. Results: The mean age was 45 +/- 9 years (between24 – 75 years), the parity was 5 +/- 4, normal colposcopy findings were found in n= 66 women,while abnormal findings were found in n=79 women. In the abnormal colposcopic finding groupn=63 had abnormal histopathology (p<0.001) abnormal histopathology was found in n=11women who had normal colposcopic findings (16.67% false negative), the calculated sensitivityand specificity of colposcopy was determined to be 86% and 79%. For pap smear abnormalitywas found in n= 49 patients, out of which n=29 had abnormal findings on histopathology aswell. And for colposcopy and pap smear out of n= 78 patients who had abnormal colposcopicfindings, abnormal pap smear was found in only n= 28 patients. And out of those who hadnormal colposcopy n= 67, n= 21 had abnormal pap smear (False positivity of 31.34%) similarlyout of those who had normal pap smear n= 96, n= 44 had abnormal histopathology (falsenegativity of 45.83%). The calculated sensitivity and specificity of pap smear was 38.8% and71.8% respectively. Conclusion: We have concluded that there is a strong correlation betweenfindings of colposcopy and histopathological diagnosis, but when it comes to the diagnosismade by pap smear and colposcopy and pap smear and histopathology the correlation is weakand not consistent.