Sensitivity of colposcopy in diagnosis of cervical neoplasia in abnormal Pap smear women

Abstract

From January 1991 to December 1991, colposcopy was performed in 80 cases From 85 cases of newly detected abnormal Pap smear. Final diagnoses were made in 69 Cases. Five cases are waiting for final results. Six cases did not agree to participate. Nineteen cases (23.75%) are unsatisfactory colposcopic examination. In this group, conization or hysterectomy was performed in 15 cases (78.94 %). Fifty Six cases (76.25 %) are satisfactory examination. Final diagnoses were made in 54 cases. Conization or Hysterectomy were performed in 34 cases (62.9 %). The incidence of cervical neoplasia in women who have abnormal Pap smear in Gynecology Unit of Bhumipol Hospital is 81.1 percent (true positive cases). The false Positive diagnosis of Pap smear is 18.9 percent. Overall sensitivity of colposcopy in diagnosis of Cervical Neoplasia in 69 abnormal Pap smear women is %. The overall accuracy of colposcopy in 49 cases with final tissue diagnosis from Conization or Hysterectomy was 84 %. Colposcopy diagnosed the disease stage less severe than final histopathology in 16 % of the patients. The sensitivity of colposcopy in diagnosis of cervical neoplasia in 54 satisfactory cases Was 94.87%. The accuracy of colposcopic directed biopsy compared with final tissue diagnoses in 34 satisfactory cases was 85.18 %. Although colposcopy has high sensitivity and accuracy, the clinical application is limited because missed diagnosis cases were in serious stage. The application of colposcopy must carefully avoid the wrong diagnosis of disease from upper genital tract such as uterine cancer. Colposcopy could not replace conization in the diagnosis of cervical neoplasia. To use colposcopy in this setting, the colposcopists had to gain more experience than this situation.