Colposcopy As An Adjunct To Cytology In The Diagnosis Of Cervical Pre-Cancer And Cancer In An Executive Health Care Set-Up: A Retrospective Study In Mumbai, India

Yogesh SHASHIKANTH, J.N.Medical College and Belgaum Cancer Hospital, India
MATTI R. 3 , MALLAPUR M. 4

1 Associate Professor, Department of Community Medicine, J.N.Medical College, KLE University, Belgaum, Karnataka, India
2 Preventive Oncologist, KLE Society's Belgaum Cancer Hospital, Belgaum, Karnataka, India
3 Department of Obstetrics and Gynaecology, Hiranandani Hospital, Powai, Mumbai, India
4 Assistant Professor in Biostatistics, Department of Community Medicine, J.N.Medical College, KLE University, Belgaum, Karnataka

Purpose: Cervical cancer is one of the major public health problem in India. There is no organized screening in place. Cytology performed sporadically in various centres throughout the country, which has its own limitations. Colposcopy, of late has shown promise in the detection of cervical pre cancers and cancers as an adjunct to cytology.

Methods: This is a hospital based retrospective study conducted in a corporate hospital in Mumbai, India. Women attending the Obstetrics and Gynaecology department during August 2010 to July 2012 were included in the study based on history and clinical findings. The Pap smear which was part of health care package was collected and processed by conventional method and reported by Bethesda system. The results of Pap smear were given to women when they returned within a month of Pap smear examination. Whatever the cytology report was, the women in the age group of 25-70 years with history of chronic leucorrhoea, post coital bleeding, post-menopausal bleeding, irregular or inter menstrual bleeding and whose cervix appeared unhealthy on examination as well as those whose pap report was abnormal, colposcopy was performed. Histopathology was considered as reference standard to compare the results of cytology and colposcopy.

Results: A total of 143 women attended the hospital. About 57% of women had come for routine examination. Comparison between Pap smear and colposcopy showed fair agreement. Pap smear showed only 9.09% sensitivity and 88.57% specificity when compared with histopathology. Positive predictive value was 20% and negative predictive value was 75.61%. Colposcopy showed 100% sensitivity and 74.28% specificity when compared with histopathology. Positive predictive value was 55% and negative predictive value was 100%.

Conclusions: Colposcopy is an ideal method to diagnose cervical pre cancer and cancer when used as an adjunct to cytology.

Funding source: Nil