Diagnostic Performance between Colposcopy Findings and Histopathology Reports

Abstract

Background: Cervical cancer is the most frequent cancer in women worldwide. With appropriate screening, the condition can be prevented and treated. Colposcopy is a useful tool in the diagnosis and management of precancerous cervical lesions following primary screening. The gold standard for identifying precancerous lesions is histopathology. Objective: The aim of this study is to evaluate the diagnostic performance between colposcopy findings and histopathology reports Methods: The cross-sectional observational study was conducted in the Department of Colposcopy Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2022 to June 2023. A total of 62 subjects were included in the study. The questionnaire was pretested, corrected and finalized. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, the mean age was found to be 36.8±11.9 years, with a range from 20 to >51 years maximum 44 (71.0%) of the patients were within the age group of 20 - 40 years. The majority 37 (59.7%) of patients completed SSC and most of the patients 56 (90.3%) were housewives. Most of the patients 59 (95.2%) were Muslims and about 32 (51.6%) came from middle-income families. About 25 (40.3%) patients were married between the ages of 15-17 years. About 25 (40.3%) were between 16-18 years during their first delivery and about 26 (41.9%) had 3-4 children and 21 (33.9%) had more than 4 children. Most of the patients 43(69.4%) had history of received OCP. Regarding colposcopic diagnosis, 12.9% (n=8) were normal, 69.4% (n=43) were CIN I, 9.7% (n=6) were CIN II and 8.1% (n=5) were CIN III and 30.6% (n=19) chronic cervicitis, 46.8% (n=29) CIN I, 6.5% (n=4) CIN II, 6.5% (n=4) CIN III, 4.8% (n=3) carcinoma in situ and 4.8% (n=3) were invasive squamous cell carcinoma by the histopathological diagnosis. Conclusion: Colposcopy had a rather high diagnostic accuracy for histopathologically verified precancerous cervical lesions. Even if the results of the screening tests are normal, patients who report with postcoital and postmenopausal bleeding should have colposcopies and biopsies. Colposcopy also has a high sensitivity, therefore it is simple to use the "see and treat" approach to lower dropout rates.