Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions

Background: The purpose of this research is to estimate the rate of concordance, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy for high-grade squamous lesions and carcinomas (HSIL+). Methods: We conducted a retrospective study of colposco...

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Main Authors: Frederik A. Stuebs, Anna K. Dietl, Annika Behrens, Werner Adler, Carol Geppert, Arndt Hartmann, Antje Knöll, Matthias W. Beckmann, Grit Mehlhorn, Carla E. Schulmeyer, Paul Gass, Martin C. Koch
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/12/10/2436
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author Frederik A. Stuebs
Anna K. Dietl
Annika Behrens
Werner Adler
Carol Geppert
Arndt Hartmann
Antje Knöll
Matthias W. Beckmann
Grit Mehlhorn
Carla E. Schulmeyer
Paul Gass
Martin C. Koch
author_facet Frederik A. Stuebs
Anna K. Dietl
Annika Behrens
Werner Adler
Carol Geppert
Arndt Hartmann
Antje Knöll
Matthias W. Beckmann
Grit Mehlhorn
Carla E. Schulmeyer
Paul Gass
Martin C. Koch
author_sort Frederik A. Stuebs
collection DOAJ
description Background: The purpose of this research is to estimate the rate of concordance, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy for high-grade squamous lesions and carcinomas (HSIL+). Methods: We conducted a retrospective study of colposcopies performed in the certified Dysplasia Unit in Erlangen between January 2015 and May 2022 (7.5 years). The colposcopic findings were correlated with biopsies obtained during examinations or surgery. Cases without histology were excluded. The primary outcome was the rate of concordance between the colposcopic and histological findings in relation to the type of transformation zone (TZ), examiner’s level of experience and age of the patients. Results: A total of 4778 colposcopies in 4001 women were analyzed. The rates of concordance for CIN I/LSIL, CIN II/HSIL, CIN III/HSIL, and carcinoma were 43.4%, 59.5%, 78.5%, and 53.9%, respectively. The rate of concordance was lowest for TZ3 and highest for colposcopists with more than 10 years’ experience. Conclusions: Colposcopy is an important, feasible, and effective method. Careful work-up needs to be performed for women with TZ3 who are over 35 years old, as they are at the highest risk of being misdiagnosed. The highest concordance for detecting HSIL+ was seen for colposcopists with >10 years’ experience.
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spelling doaj.art-2909e0b56de54ef699386421bb61e4ed2023-11-23T23:45:17ZengMDPI AGDiagnostics2075-44182022-10-011210243610.3390/diagnostics12102436Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial LesionsFrederik A. Stuebs0Anna K. Dietl1Annika Behrens2Werner Adler3Carol Geppert4Arndt Hartmann5Antje Knöll6Matthias W. Beckmann7Grit Mehlhorn8Carla E. Schulmeyer9Paul Gass10Martin C. Koch11Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, GermanyDepartment of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, GermanyDepartment of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, GermanyDepartment of Medical Informatics, Biometry and Epidemiology, Friedrich Alexander University of Erlangen—Nuremberg, Waldstrasse 6, 91054 Erlangen, GermanyInstitute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Krankenhausstrasse 8–10, 91054 Erlangen, GermanyInstitute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Krankenhausstrasse 8–10, 91054 Erlangen, GermanyInstitute of Clinical and Molecular Virology, Erlangen University Hospital, Friedrich Alexander University of Erlangen—Nuremberg, Schlossgarten 4, 91054 Erlangen, GermanyDepartment of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, GermanyInstitute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Krankenhausstrasse 8–10, 91054 Erlangen, GermanyDepartment of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, GermanyDepartment of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen—European Metropolitan Area of Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen—Nuremberg, Universitaetsstrasse 21–23, 91054 Erlangen, GermanyDepartment of Gynecology and Obstetrics, Hospital ANregiomed Ansbach, Escherichstrasse 1, 91522 Ansbach, GermanyBackground: The purpose of this research is to estimate the rate of concordance, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of colposcopy for high-grade squamous lesions and carcinomas (HSIL+). Methods: We conducted a retrospective study of colposcopies performed in the certified Dysplasia Unit in Erlangen between January 2015 and May 2022 (7.5 years). The colposcopic findings were correlated with biopsies obtained during examinations or surgery. Cases without histology were excluded. The primary outcome was the rate of concordance between the colposcopic and histological findings in relation to the type of transformation zone (TZ), examiner’s level of experience and age of the patients. Results: A total of 4778 colposcopies in 4001 women were analyzed. The rates of concordance for CIN I/LSIL, CIN II/HSIL, CIN III/HSIL, and carcinoma were 43.4%, 59.5%, 78.5%, and 53.9%, respectively. The rate of concordance was lowest for TZ3 and highest for colposcopists with more than 10 years’ experience. Conclusions: Colposcopy is an important, feasible, and effective method. Careful work-up needs to be performed for women with TZ3 who are over 35 years old, as they are at the highest risk of being misdiagnosed. The highest concordance for detecting HSIL+ was seen for colposcopists with >10 years’ experience.https://www.mdpi.com/2075-4418/12/10/2436cervical intraepithelial neoplasiacolposcopycervical cancercervical cancer screening assessment
spellingShingle Frederik A. Stuebs
Anna K. Dietl
Annika Behrens
Werner Adler
Carol Geppert
Arndt Hartmann
Antje Knöll
Matthias W. Beckmann
Grit Mehlhorn
Carla E. Schulmeyer
Paul Gass
Martin C. Koch
Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
Diagnostics
cervical intraepithelial neoplasia
colposcopy
cervical cancer
cervical cancer screening assessment
title Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
title_full Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
title_fullStr Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
title_full_unstemmed Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
title_short Concordance Rate of Colposcopy in Detecting Cervical Intraepithelial Lesions
title_sort concordance rate of colposcopy in detecting cervical intraepithelial lesions
topic cervical intraepithelial neoplasia
colposcopy
cervical cancer
cervical cancer screening assessment
url https://www.mdpi.com/2075-4418/12/10/2436
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