Publication:

Agreement between cytology, colposcopy and histopathology in assessment of precancerous cervical lesions

Background Cervical cancer ranks as the third most common gynaecologic cancer in the world. The incidence rate for cervical cancer in Australia is 7.1 cases per 100,000 females as per 2022 data. Reduction in cervical cancer morbidity and mortality is based on the early detection of premalignant lesions. The aim of this clinical audit was to evaluate the agreement between the histology findings and CST LBC results/colposcopy impression in assessment of precancerous cervical lesions in all patients referred for colposcopy in view of abnormal cervical cytology.

Methods This retrospective study included 108 participants. The study was conducted from June 2022 to May 2023 at blinded for review method. Cervical biopsy was performed on 48 cases out of the total 108 women based on colposcopy findings. The significance of the association between CST LBC result and colposcopy impression with histology of biopsy specimen was performed using the Chi-square test or Fisher’s exact.

Results More than two-thirds of the colposcopy impressions (n=22/32, 68.75%) indicated LSIL matched the results of the biopsy findings. More than 80% of the CST results indicating HSIL (n=14/16, 87.50%) matched biopsy findings. Two-thirds of the CST results (n=14) indicated LSIL matched the results of the biopsy findings. The weighted Kappa measure for agreement between CST LBC result and biopsy findings was 0.464, 95% CI: 0.20-0.73.

Conclusions Correlation of CST LBC result and colposcopy with histopathology, as the diagnostic tool in this study, was significant (p<0.001) Combination of cytology and colposcopy helped in the successful identification of pre-malignant lesions.