PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions
Introduction: The incidence of cervical cancer is very high in developing countries. The extensive use of cervical screening with PAP smear and colposcopy has considerably increased the detection of premalignant and malignant cervical lesions. Methods: This was a hospital-based study conducted over...
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Lumbini Medical College
2022-12-01
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| Series: | Journal of Lumbini Medical College |
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| Online Access: | https://jlmc.edu.np/index.php/JLMC/article/view/487 |
| _version_ | 1811198339057713152 |
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| author | Arati Shrestha Kopila Sunwar Miki Shah Sunita Thapa Aruna Pokharel Deepak Shrestha Archana Tiwari |
| author_facet | Arati Shrestha Kopila Sunwar Miki Shah Sunita Thapa Aruna Pokharel Deepak Shrestha Archana Tiwari |
| author_sort | Arati Shrestha |
| collection | DOAJ |
| description |
Introduction: The incidence of cervical cancer is very high in developing countries. The extensive use of cervical screening with PAP smear and colposcopy has considerably increased the detection of premalignant and malignant cervical lesions. Methods: This was a hospital-based study conducted over a period of three months. All the patients underwent gynecological examination, PAP smear and colposcopy. In case of abnormal findings in colposcopy or follow-up cytology, patients were advised for cervical biopsy. With reference to the histopathological reports, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PAP smear and colposcopy were evaluated. Results: The most common cytological result was Negative for Intraepithelial Lesion or Malignancy (NILM, 60%) followed by Atypical Squamous Cells of Undetermined Significance (ASCUS, 10%), Atypical Squamous Cells- cannot exclude High grade lesion (ASC-H, 6%), Low grade Squamous Intraepithelial Lesion (LSIL,10%) and High grade Squamous Intraepithelial Lesion (HSIL, 11%). In colposcopy, 60% of the patients were normal and 40% showed atypical transition zone. Histo-pathological findings among 53 patients were NILM (13.2%), cervicitis (13.2%), Cervical Intraepithelial Neoplasia I (CIN I, 28.3%), CIN II and CIN III (39.6%) and invasive carcinoma (5.66%). The sensitivity, specificity, PPV and NPV of PAP smear were 63.6%, 66.6%, 33.3%, and 87.5% respectively. Similarly sensitivity, specificity, PPV, NPV of colposcopy for abnormal cervical lesions were 87.56%, 15.38%, 76.09% and 28.57% respectively. Conclusion: In the absence of HPV-DNA testing, the combined use of PAP smear and colposcopy to detect premalignant and malignant cervical lesions increases early detection and treatment.
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| first_indexed | 2024-04-12T01:28:41Z |
| format | Article |
| id | doaj.art-88d699751497426fae456921edf881bd |
| institution | Directory Open Access Journal |
| issn | 2392-4632 2542-2618 |
| language | English |
| last_indexed | 2024-04-12T01:28:41Z |
| publishDate | 2022-12-01 |
| publisher | Lumbini Medical College |
| record_format | Article |
| series | Journal of Lumbini Medical College |
| spelling | doaj.art-88d699751497426fae456921edf881bd2022-12-22T03:53:33ZengLumbini Medical CollegeJournal of Lumbini Medical College2392-46322542-26182022-12-0110110.22502/jlmc.v10i1.487PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical LesionsArati Shrestha0Kopila Sunwar1Miki Shah2Sunita Thapa3Aruna Pokharel4Deepak Shrestha5Archana Tiwari6Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal.Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal.Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal.Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal.Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal.Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal.Lumbini Medical College and Teaching Hospital, Tansen-7, Palpa, Nepal. Introduction: The incidence of cervical cancer is very high in developing countries. The extensive use of cervical screening with PAP smear and colposcopy has considerably increased the detection of premalignant and malignant cervical lesions. Methods: This was a hospital-based study conducted over a period of three months. All the patients underwent gynecological examination, PAP smear and colposcopy. In case of abnormal findings in colposcopy or follow-up cytology, patients were advised for cervical biopsy. With reference to the histopathological reports, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PAP smear and colposcopy were evaluated. Results: The most common cytological result was Negative for Intraepithelial Lesion or Malignancy (NILM, 60%) followed by Atypical Squamous Cells of Undetermined Significance (ASCUS, 10%), Atypical Squamous Cells- cannot exclude High grade lesion (ASC-H, 6%), Low grade Squamous Intraepithelial Lesion (LSIL,10%) and High grade Squamous Intraepithelial Lesion (HSIL, 11%). In colposcopy, 60% of the patients were normal and 40% showed atypical transition zone. Histo-pathological findings among 53 patients were NILM (13.2%), cervicitis (13.2%), Cervical Intraepithelial Neoplasia I (CIN I, 28.3%), CIN II and CIN III (39.6%) and invasive carcinoma (5.66%). The sensitivity, specificity, PPV and NPV of PAP smear were 63.6%, 66.6%, 33.3%, and 87.5% respectively. Similarly sensitivity, specificity, PPV, NPV of colposcopy for abnormal cervical lesions were 87.56%, 15.38%, 76.09% and 28.57% respectively. Conclusion: In the absence of HPV-DNA testing, the combined use of PAP smear and colposcopy to detect premalignant and malignant cervical lesions increases early detection and treatment. https://jlmc.edu.np/index.php/JLMC/article/view/487ColposcopyCytologyPAP smearPre-malignantInvasive carcinoma |
| spellingShingle | Arati Shrestha Kopila Sunwar Miki Shah Sunita Thapa Aruna Pokharel Deepak Shrestha Archana Tiwari PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions Journal of Lumbini Medical College Colposcopy Cytology PAP smear Pre-malignant Invasive carcinoma |
| title | PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions |
| title_full | PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions |
| title_fullStr | PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions |
| title_full_unstemmed | PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions |
| title_short | PAP Smear versus Colposcopy in the Absence of HPV-DNA Testing for the Screening of Pre-malignant and Malignant Cervical Lesions |
| title_sort | pap smear versus colposcopy in the absence of hpv dna testing for the screening of pre malignant and malignant cervical lesions |
| topic | Colposcopy Cytology PAP smear Pre-malignant Invasive carcinoma |
| url | https://jlmc.edu.np/index.php/JLMC/article/view/487 |
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