Screening for Carcinoma Cervix by Comparing Pap Smear Cytology, Histopathology with Colposcopy in Unhealthy Cervix

Abstract

Introduction: Cervical cancer is one of the most frequent genital tract cancers and accounts for 80% of all female cancers worldwide. Annually, the incidence is about five lacs and 2,80,000 people die due to carcinoma cervix yearly. In India, 1,26,000 new cases are detected and 71,000 deaths occur annually. Cervical cancer is a preventable condition, since it is associated with prolonged preinvasive stage, so that early screening and appropriate treatment can be undertaken to prevent the progression into invasive stage. Aim: To compare Papanicolaou (Pap) smear cytology, colposcopy and colposcopy guided biopsy (histopathology) in detecting premalignant and malignant lesions of the cervix. Materials and Methods: A cross-sectional study was carried out in Department of Obstetrics and Gynaecology at RL Jalappa Hospital and Research Centre, Kolar, Karnataka, India. The study period was from October 2018 to June 2020 and 90 study subjects were included in the study. All the study subjects enrolled were subjected to Papanicolaou (Pap) smear, colposcopy and colposcopy directed biopsy. The data was statistically analysed for sensitivity, specificity, positive predictive value, negative predictive value and accuracy of pap smear and colposcopy, with considering colposcopy directed biopsy as the gold standard for diagnosis. Results: Maximum number of women was found in the age group of more than 50 years (44.4%), mean age was 52±11 years. Majority of the women were multipara accounting for 95.6%. Pap smear had a sensitivity and specificity of 69.2% and 88.2%, respectively. The colposcopy had sensitivity of 97.37% specificity of 88.46 as Pap smear. Conclusion: Colposcopy has a good association with Pap smear and histopathology in diagnosis of premalignant and malignant lesion in unhealthy cervix. Hence, its satisfactory diagnostic efficacy makes it a realiable for diagnosis of malignant and pre malignant lesion.

Keywords

• atypical squamous cell carcinoma
• cervical malignancy
• papanicolaou smear