Correlation between Colposcopy and Histopathologic Diagnosis from Colposcopy-Guided Biopsies

Cervical cancer is preventable and curable when detected in its early stages. Colposcopy with biopsy is used in the evaluation and management of patients with cervical lesions.  The aims of this study are to correlate the colposcopic diagnosis to the actual histopathologic diagnosis, and to determine the accuracy, sensitivity and specificity of acetowhitening in distinguishing premalignant and malignant lesions of the cervix. Review of slides and patient charts were done on 121 patients who underwent colposcopy with biopsy at the Outpatient department (OPD) of the Philippine General Hospital (PGH).  Statistical analysis was done using chi square approximation.  Histologic results revealed that there were four malignant or suspicious for malignancy cases, 3 cases of cervical intraepithelial neoplasia 3 and 96 benign cases.  The accuracy of colposcopy was found to be 43% (95% CI:  34-54%). The sensitivity of acetowhitening was 71% (95% CI: 29-96%) while the specificity of acetowhitening was 42% (95% CI:  32-52%).  This study showed that colposcopy is a good screening tool in detecting high-grade lesions but must be used with caution because of its low specificity.  Low specificity of colposcopy in the OPD may be attributed to the varying levels of expertise of the colposcopists.

 

Keywords: pathology, cervical cancer, colposcopy