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 Matti Renuka1, Kumar Yogesh S2,*, Mallapur MD3 1Consultant Obstetrician and Gynaecologist, Hiranandani Hospital, Powai, Mumbai 2Associate Professor, Department of Preventive and Social Medicine, J.N. Medical College, KLE University, Nehrunagar, Belgaum 3Assistant Professor, Department of Preventive and Social Medicine, J.N. Medical College, KLE University, Nehrunagar, Belgaum *Corresponding author: Yogesh Kumar S Associate Professor, Department of Preventive and Social Medicine, J.N. Medical College, KLE University, Nehrunagar, Belgaum-590010 Email: yogeshkumar23@gmail.com
Online published on 18 July, 2017. Abstract Background Cervical cancer is one of the major public health problem in India. There is no organized screening in place. Cytology performed sporadically in various centers throughout the country, which has its own limitations. Colposcopy, of late has shown promise in the detection of cervical pre cancers and cancers. Aim To evaluate the performance of colposcopy in the detection of cervical pre cancers and cancers when used as an adjunct to cytology. Method This is a hospital based retrospective study conducted in a corporate hospital in Mumbai, India. Women attending the Obstetrics and Gynecology department between 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 Atotal 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. Top Keywords Colposcopy, Cytology, Cervical pre-cancer, Cancer. Top |