Pap test accuracy and severity of squamous intraepithelial lesion.

BACKGROUND: Cytology smears and guided biopsies are the most widely used diagnostic standards for cervical cancer (CC) screening in the developing countries. AIM: To evaluate the performance of conventional cytology in estimating the presence and grade of cervical disease against the reference standard of histopathology. SETTINGS AND DESIGN: After primary screening for CC, directed biopsies were performed and compared with histopathology results. MATERIALS AND METHODS: Papanicolaou (Pap) smears and biopsies from 3194 women in the age group of 14-98 years were included. Cytology results were provided by doctors who performed the cervical biopsies. STATISTICAL ANALYSIS: The accuracy of Pap smear was measured by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculated using the statistical analysis program PSPP 0.7.8. RESULTS: The sensitivity of conventional cytology (Pap smear) for women with low-grade cervical intraepithelial neoplasia or less serious lesions (CIN1-) was 93% and specificity was 73%. The sensitivity and specificity of cytology for women with high-grade cervical intraepithelial neoplasia or cancer (CIN2+) was 64% and 84%, respectively. CONCLUSION: Cytology is a sufficiently sensitive test for detection of cervical lesions and can be used as a primary testing tool to triage.