Colposcopic Evaluation of the
Unhealthy Cervix
1026-1028
Correspondence
Dr. Ramesh G.
447, Vishwapriya Layout
16 th cross, 2nd block, Begur road. Bangalore-68, India.
Phone: 09845175241
E-mail: docrami@rediffmail.com
Background: The Papanicolaou’s (Pap) smear is the primary screening tool for Cervical Intra-epithelial Neoplasia (CIN) and for invasive cancer of the uterine cervix. Recently, the assumed accuracy of the Pap smear which was found to be 80% to 95% for detecting CIN and early invasive cancer, was questioned. The simultaneous use of cytological studies and screening colposcopy has been shown to increase the rate of the cervical cancer detection. Hence, there is an obvious need to subject the women with clinically unhealthy cervix to colposcopy and directed biopsy. This study is done to evaluate the role of colposcopy in detecting unhealthy cervix. Aims: To study the role of colposcopy in the evaluation of unhealthy cervix, to localize the lesions and to obtain biopsies from the selected areas.
Study Design: A prospective, clinical study.
Materials and Methods: 80 patients who were aged between 25-65 years and had clinically unhealthy cervix, were subjected to a colposcopic evaluation and the findings were noted. All the patients underwent both the acetic acid and the Schiller’s test before they were subjected to colposcopic directed biopsies. The biopsies were taken from the acetowhite areas and the iodine negative areas.
Results: Out of the 80 patients, 21 (26.25%) had normal colposcopic findings. The colposcopic evaluation and the guided biopy were successful in detecting abnormalities in 20 out of 24 cases. The incidence of CIN 1 and CIN 2,3 was found to be 11.25% and 10% respectively.The sensitivity of colposcopy in the present study is 83.33%.
Conclusions: The value of colposcopy has been recognized, mainly in the evaluation of patients with abnormal cervical smears because of their less sensitive and false negative cytologies and because of the poor compliance of the patients for follow up. It has been felt that apart from cervical smears, colposcopy should be offered as diagnostic method in all the patients with unhealthy cervix.