Open AccessColposcopy and additive diagnostic value of biopsies from colposcopy‐negative areas to detect cervical dysplasia
Author(s) -
Baasland Ingrid,
Hagen Bjørn,
Vogt Christina,
Valla Marit,
Romundstad Pål R.
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13009
Subject(s) - colposcopy , medicine , endocervical curettage , cervical intraepithelial neoplasia , curettage , gynecology , cervix , dysplasia , obstetrics , biopsy , cervical cancer , radiology , cancer
We evaluated colposcopy in the routine diagnostic workup of women with abnormal cervical cytology, as well as the diagnostic value of endocervical curettage material and biopsies taken from colposcopy‐positive and colposcopy‐negative quadrants of the cervix. Material and methods This cross‐sectional study included 297 nonpregnant women with abnormal cervical cytology and no prior treatment for cervical dysplasia or cancer. All women underwent gynecological examination, colposcopy, endocervical curettage, and had cervical biopsies taken. Colposcopy was considered satisfactory if the squamocolumnar junction was fully visible, and biopsies were taken from all four quadrants of the cervix, regardless of colposcopy results. Results In all, 130 of the women in our study had satisfactory colposcopy results and were diagnosed with cervical intraepithelial neoplasia grade 2 or worse (CIN2+), 61% via a colposcopy‐positive biopsy and 39% via a colposcopy‐negative biopsy. Eighty‐seven of them had positive colposcopy results, but CIN2+ was histologically verified from colposcopy‐positive biopsies in 91% ( n = 79) and from colposcopy‐negative biopsies in 9% ( n = 8). The remaining 43 women with CIN2+ had negative colposcopy findings, so their diagnosis was verified in colposcopy‐negative biopsies. The sensitivity of colposcopy alone to detect CIN2+ was 61% (95% CI 52–69). Conclusions In the present study, colposcopy was not a stand‐alone diagnostic method. Colposcopy‐negative biopsies had a clear additive value, identifying a substantial proportion of women with both positive and negative colposcopy results with treatment‐worthy cervical dysplasia. Endocervical curettage material had little diagnostic value in this study.