Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
Frederik A. Stuebs,
Anna K. Dietl,
Annika Behrens,
Werner Adler,
Carol Geppert,
Arndt Hartmann,
Antje Knöll,
Matthias W. Beckmann,
Grit Mehlhorn,
Carla E. Schulmeyer,
Paul Gass,
Martin C. Koch
Affiliations
Frederik A. Stuebs
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
Anna K. Dietl
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
Annika Behrens
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
Werner Adler
Department of Medical Informatics, Biometry and Epidemiology, Friedrich Alexander University of Erlangen—Nuremberg, Waldstrasse 6, 91054 Erlangen, Germany
Carol Geppert
Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Krankenhausstrasse 8–10, 91054 Erlangen, Germany
Arndt Hartmann
Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Krankenhausstrasse 8–10, 91054 Erlangen, Germany
Antje Knöll
Institute of Clinical and Molecular Virology, Erlangen University Hospital, Friedrich Alexander University of Erlangen—Nuremberg, Schlossgarten 4, 91054 Erlangen, Germany
Matthias W. Beckmann
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
Grit Mehlhorn
Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Krankenhausstrasse 8–10, 91054 Erlangen, Germany
Carla E. Schulmeyer
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
Paul Gass
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, Germany
Martin C. Koch
Department of Gynecology and Obstetrics, Hospital ANregiomed Ansbach, Escherichstrasse 1, 91522 Ansbach, Germany
Background: The purpose of this research is to estimate the rate of concordance, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy for high-grade squamous lesions and carcinomas (HSIL+). Methods: We conducted a retrospective study of colposcopies performed in the certified Dysplasia Unit in Erlangen between January 2015 and May 2022 (7.5 years). The colposcopic findings were correlated with biopsies obtained during examinations or surgery. Cases without histology were excluded. The primary outcome was the rate of concordance between the colposcopic and histological findings in relation to the type of transformation zone (TZ), examiner’s level of experience and age of the patients. Results: A total of 4778 colposcopies in 4001 women were analyzed. The rates of concordance for CIN I/LSIL, CIN II/HSIL, CIN III/HSIL, and carcinoma were 43.4%, 59.5%, 78.5%, and 53.9%, respectively. The rate of concordance was lowest for TZ3 and highest for colposcopists with more than 10 years’ experience. Conclusions: Colposcopy is an important, feasible, and effective method. Careful work-up needs to be performed for women with TZ3 who are over 35 years old, as they are at the highest risk of being misdiagnosed. The highest concordance for detecting HSIL+ was seen for colposcopists with >10 years’ experience.
