Analysis of Cervical Cytology, Colposcopy and Biopsy Results

Abstract

Aim: Cervical cancer incidence and mortality have been significantly reduced by the regular and population based application of cervical cancer screening programme. Five percent of patients in screening programme need to be treated with further diagnostic tools. The most commonly used technique for further evaluation is colposcopy. In this study we evaluated the results of colposcopy procedure, which had been carried out in our clinical setting, together with the cytology and tissue biopsy results. Material and Method: One hundred ninety colposcopy procedures, which had been carried out in gynecology clinic of Namik Kemal University Faculty of Medicine, Department of Obstetrics and Gynecology, were evaluated retrospectively. Colposcopy indications and results, cytology results and biopsy results were evaluated. Results: The mean age of the population was 42.8 +/- 10.4. Forty-four (23.2%) of patients were postmenopausal and 146 (76.8%) were premenopausal. The 51 (26.8%) patients were smoking. Colposcopy indication for 42 (22.1%) patients was visible lesions on the cervix. Colposcopy indication for the rest of the population was abnormal cervical smear results. Colposcopy was negative for the 49 (25.8%) patients. The biopsies revealed no dysplasia for 153 (80.5%) patients, CIN 1 for 17 (8.9%) patients, CIN 2 for 9 (4.7%) patients, CIN 3 for 7 (3.7%) patients, in situ squamous carcinoma for 2 (1.1%) patients, squamous carcinoma for 2 (1.1%) patients. Random biopsies from colposcopy negative patients revealed CIN 3 for 1 patient and CIN 2 for 2 patients. These 3 patients represented 6.1% of colposcopy negative patients. The sensitivity of colposcopy for detecting CIN 2 and higher-grade lesions were 85 % in our study. Discussion: The main goal of the cervical screening programme is to detect CIN 3 lesions. Our results supports recent findings in literature suggesting random cervical biopsies in colposcopy negative patients, especially in patients who have risk for high-grade dysplasia in their cervical smear such as HSIL or ASC-H, should be done to improve sensitivity of colposcopy.