Knowledge of cytology results affects the performance of colposcopy: a crossover study.
BMC Womens Health
; 24(1): 189, 2024 Mar 21.
Article
em En
| MEDLINE
| ID: mdl-38515088
ABSTRACT
OBJECTIVE:
To determine whether knowledge of cytology affects the colposcopist's diagnostic accuracy in the identification of cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2).METHOD:
In this cross-over study, healthcare professionals interpreted colposcopy images from 80 patient cases with known histological diagnoses. For each case, 2 images taken with a colposcope were provided (native and after acetic acid application). Inclusion criteria consisted of women with a transformation zone type 1 or 2, who had both a cytological and histological diagnosis. Cases were distributed across two online surveys, one including and one omitting the cytology. A wash-out period of six weeks between surveys was implemented. Colposcopists were asked to give their diagnosis for each case as < CIN2 or ≥ CIN2 on both assessments. Statistical analysis was conducted to compare the two interpretations.RESULTS:
Knowledge of cytology significantly improved the sensitivity when interpreting colposcopic images, from 51.1% [95%CI 39.3 to 62.8] to 63.7% [95%CI 52.1 to 73.9] and improved the specificity from 63.5% [95%CI 52.3 to 73.5] to 76.6% [95%CI 67.2 to 84.0]. Sensitivity was higher by 38.6% when a high-grade cytology (ASC-H, HSIL, AGC) was communicated compared to a low-grade cytology (inflammation, ASC-US, LSIL). Specificity was higher by 31% when a low-grade cytology was communicated compared to a high-grade.CONCLUSIONS:
Our data suggests that knowledge of cytology increases sensitivity and specificity for diagnosis of ≥ CIN2 lesions at colposcopy. Association between cytology and histology may have contributed to the findings.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Displasia do Colo do Útero
/
Neoplasias do Colo do Útero
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Infecções por Papillomavirus
Limite:
Female
/
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article