Colposcopic Evaluation of Clinically Unhealthy Cervix

Abstract

Cervical cancer is the commonest malignancy found amongst Bangladeshi women and the third most common cancer in the world. New cases of invasive cervical cancer are diagnosed over 5,00,000 annually worldwide. For Cervical Intra-Epithelial Neoplasia (CIN) and for invasive cancer of the uterine cervix, Papanicolaou’s (Pap) smear is the primary screening tool. The Pap smear accuracy, which was recently assumed found to be 80% to 95% for detecting CIN and early invasive cancer, was questioned. Colposcopy and directed biopsy are needed to clarify the clinically unhealthy cervix in women. This study was conducted to evaluate the role of colposcopy in identifying. The aim of the study was to assess the role of colposcopy of the unhealthy cervix to localize the lesions and to obtain biopsies from the selected areas. This prospective observational study conducted from January 2016 to December 2016 in the Department of Obstetrics and Gynaecology, Sikder Medical College, Dhaka including 104 patients who were aged between 25-65 years with clinically unhealthy cervix, were exposed to a colposcopic evaluation. All the patients underwent colposcopic-directed biopsies. The biopsies were taken from the act white areas and the iodine negative areas. Among 104 patients, 49 (47.1%) were in the age group of 25-34 years. In the parity, 97 (93.3%) 0-4 child, 61 (58.7%) were married before 18 years of age. 17 (16.35%) had normal colposcopic findings. The colposcopic evaluation and the guided biopsy were successful in detecting abnormalities in 26 out of 31 cases. The incidence of CIN 1 and CIN2, 3 were found colposcopically and histologically 33.65%, 24.04%, and 11.54%, respectively. In the present study, the sensitivity of colposcopy was 83.33%. Both the neoplastic and the non-neo-plastic ones, colposcopy was found to be useful in understanding the morphology of the cervical lesions and this would very helpful in planning their management in the future.