Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

  • Published : 2014.01.15
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Abstract

Aim: To evaluate the agreement between colposcopic diagnosis and cervical pathology a retrospective chart review was performed. Materials and Methods: This study included 437 patients who underwent colposcopy and cervical biopsy or conization at Siriraj Hospital from October 2010 - December 2012. The patient clinical characteristics, cervical cytology results, colposcopic diagnoses, cervical pathology results were recorded and correlations between variables were analyzed. Results: Agreement of colposcopic diagnosis and cervical pathology was matched in 253 patients (57.9%). The strength of agreement with weighted Kappa statistic was 0.494 (p<0.001). Colposcopic diagnoses more often overestimated (31.1%) than underestimated (11%) the cervical pathology. Agreement of colposcopic diagnosis and cervical pathology within 1 grade was found in 411 patients (94.1%). Positive predictive value (PPV) of high grade colposcopy or more was 75.5%, whereas the negative predictive value (NPV) of insignificant and low grade colposcopy was 83.8%. False positives of high grade colposcopy or more were 21%. False negatives of insignificant or low grade colposcopy were 19.1%. Conclusions: Strength of agreement between colposcopic diagnosis and cervical pathology was found to be only moderate. A biopsy at colposcopy should be performed at a gold standard level to detect high grade lesions.

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References

  1. Baum ME, Rader JS, Gibb RK, et al (2006). Colposcopic accuracy of obstetrics and gynecology residents. Gynecol Oncol, 103, 966-70. https://doi.org/10.1016/j.ygyno.2006.06.002
  2. Bekkers RL, van de Nieuwenhof HP, Neesham DE, et al. (2008). Does experience in colposcopy improve identification of high grade abnormalities? Eur J Obstet Gynecol Reprod Biol, 141, 75-8. https://doi.org/10.1016/j.ejogrb.2008.07.007
  3. Benedet JL, Matisic JP, Bertrand MA (2004). An analysis of 84,244 patients from the British Columbia cytologycolposcopy program. Gynecol Oncol, 92, 127-34. https://doi.org/10.1016/j.ygyno.2003.10.001
  4. Brotzman GL, Schellhase KG (2004). Colposcopic proficiencydisease spectrum in a single family practice colposcopists' clinic. WMJ, 103, 61-5.
  5. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
  6. Gage JC, Hanson VW, Abbey K, et al (2006). Number of cervical biopsies and sensitivity of colposcopy. Obstet Gynecol, 108, 264-72. https://doi.org/10.1097/01.AOG.0000220505.18525.85
  7. Homesley HD, Wolff JL, Reish RL, Jobson VW (1985). Evaluating the acquisition of colposcopy skills in an obstetric-gynecologic residency program. J Reprod Med, 30, 911-4.
  8. Khunhaprema T, Attasara P, Sriplung H, et al (2012). Cancer in Thailand. Volume VI, 2004-2006. Bangkok, National Cancer Institute, Department od Medical Service, Ministry of Public Health.
  9. Louwers JA, Kocken M, ter Harmsel WA, Verheijen RH (2009). Digital colposcopy: ready for use? An overview of literature. BJOG, 116, 220-9. https://doi.org/10.1111/j.1471-0528.2008.02047.x
  10. Massad LS and Collins YC (2003). Strength of correlations between colposcopic impression and biopsy histology. Gynecol Oncol, 89, 424-8. https://doi.org/10.1016/S0090-8258(03)00082-9
  11. Massad LS, Einstein MH, Huh WK, et al (2013). 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. Obstet Gynecol, 121, 829-46. https://doi.org/10.1097/AOG.0b013e3182883a34
  12. Mitchell MF, Schottenfeld D, Tortolero-Luna G, Cantor SB, Richards-Kortum R (1998). Colposcopy for the diagnosis of squamous intraepithelial lesions: a meta-analysis. Obstet Gynecol, 91, 626-31. https://doi.org/10.1016/S0029-7844(98)00006-4
  13. Saslow D, Solomon D, Lawson HW, et al (2012). American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin, 62, 147-72. https://doi.org/10.3322/caac.21139
  14. Underwood M, Arbyn M, Parry-Smith W, et al (2012). Accuracy of colposcopy-directed punch biopsies: a systematic review and meta-analysis. BJOG, 119, 1293-301. https://doi.org/10.1111/j.1471-0528.2012.03444.x
  15. Viera AJ, Garrett JM (2005). Understanding interobserver agreement: the kappa statistic. Fam Med, 37, 360-3.

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