Colposcopic and Histopathologic Comparative Interpretations Among Patients Undergoing Evaluation for Cervical Dysplasia in Western Kenya

Abstract

Objective: To determine the correlation between colposcopic and final histopathologic results amongst patients undergoing a colposcopic evaluation in cervical dysplasia clinics in Western Kenya. Methods: This was a cross-sectional study, conducted among 164 females undergoing colposcopic evaluation across several cervical dysplasia clinics in Western Kenya. Colposcopy and histopathology were performed. Colposcopy findings were graded using modified Reid’s Colposcopic Index (RCI). Bayes’ theorem model was used to determine the sensitivity, specificity, positive predictive value, and negative predictive value. An overall ĸ value was calculated as an estimate of the strength of correlation between colposcopy and histopathology. Results: Mean age of the study participants was 40.6 years. Modified RCI classified 20.7%, 40.2%, and 39.1% between a score of 0–2, 3–5, and 6–8, respectively. Colposcopy classified 0.6%, 38.4%, and 60.1% as normal, cervical intraepithelial neoplasia (CIN) 1 (low risk), and CIN 2–3 (medium–high risk), respectively. Histopathology classified 16.5%, 26.2%, 53.3%, and 3.0% as having normal, CIN 1, CIN 2–3, or carcinoma in situ, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 85.3%, 69.7%, 80.3%, and 69.7%, respectively. The estimated strength of correlation between colposcopy and biopsy was relatively strong (ĸ=0.55). Conclusion: There is an association between the discriminatory powers of colposcopy and histology, but colposcopy had a lower specificity when compared to histopathology.