Accuracy of Pap Smear Test and Colposcopy Before and After Treatment of Cervical Premalignant Lesions

Abstract

This study aimed to estimate the sensitivity of Pap smear test and colposcopy before and after treatment of high-grade SIL (CIN2+). The medical records from 613 women were reviewed. All of them underwent excisional treatment of the cervix (LEEP) In the Georgian National Screening Center. Out of 613 women histologically confirmed CIN2+ lesion was observed in 285 women. During follow -up we considered biopsy-proven CIN2 or worse detected in a punch or re -LEEP specimen as residual/recurrent disease. Women with two consecutive negative Pap smear tests and normal colposcopy were considered as negative for residual/recurrent lesions. In all cases, a conventional Pap smear test and colposcopy were performed. The criterion standard of test accuracy was the histologic report of LEEP specimens and biopsies. Results were compared by statistical analysis. Using a disease threshold of HSIL accuracy of Pap smear test and colposcopy before the excisional treatment revealed Pap: Sensitivity 83.4%; Specificity 76.4%; PPV 72.6%; NPV76.8%; Colposcopy: Sensitivity 83.4%; Specificity 69.4%; PPV 69.3 % ; NPV 80.6 %; After the excisional treatment: Pap: Sensitivity 82.8 %; Specificity 92.3 %; PPV 61.5 %; NPV 97.3 %; Colposcopy: Sensitivity 62.1%; Specificity 80.4 %; PPV 32.1 %; NPV 93.4%. The Sensitivity of Pap smear test before and after treatment is approximately equal. The sensitivity of colposcopy is higher before treatment 83.3% than after treatment 62.1%. After excisional treatment, the Pap smear test was considered to be a more sensitive test than colposcopy.