Verification of the accuracy of cervical cytology reports in women referred for colposcopy.

摘要

OBJECTIVE: To verify the accuracy of cervical cytology in correlation with colposcopic and histological findings. DESIGN/SETTING/POPULATION/METHODS: In this retrospective chart review study 545 women, referred to the outpatient clinic for colposcopy, were included in the study. During the 4-year study period, two consultants performed the colposcopies and further necessary procedures, whereas patient charts were reviewed by two of the co-authors. RESULTS: The median age of the study population was 35 years (range: 16-65). Thirty-four percent of the cases were new and 11% of the women were referred after receiving their first ever cervical smear. Ninety-two percent (503/545) of the colposcopies were satisfactory. Concordance between colposcopic findings and the histology report was 87%, whereas concordance between cytology and histology reports was as low as 60% for HPV-related lesions, 72% for LGSIL and 86% for HGSIL. "See and Treat" was offered to 53 (10%) women and 48 (90.5%) of them had high-grade lesions on histology justifying treatment at the first visit. CONCLUSIONS: The concurrent use of cytology and colposcopy provides better chances for earlier detection of lesions demanding intervention; 80%-90% of patients with severe dyskaryotic smears will have a histology report confirming CIN III. See and treat management can be decided sometimes, if supported by the colposcopic findings, and an audit should confirm accuracy to, at least, 90% of cases.