Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2016 Nov;95(11):1258-1263.
doi: 10.1111/aogs.13009.

Colposcopy and additive diagnostic value of biopsies from colposcopy-negative areas to detect cervical dysplasia

Ingrid Baasland  1 , Bjørn Hagen  2   3 , Christina Vogt  3   4 , Marit Valla  5   4 , Pål R Romundstad  5
Affiliations
Clinical Trial

Colposcopy and additive diagnostic value of biopsies from colposcopy-negative areas to detect cervical dysplasia

Ingrid Baasland et al. Acta Obstet Gynecol Scand. 2016 Nov.

Abstract

Introduction: We evaluated colposcopy in the routine diagnostic workup of women with abnormal cervical cytology, as well as the diagnostic value of endocervical curettage material and biopsies taken from colposcopy-positive and colposcopy-negative quadrants of the cervix.

Material and methods: This cross-sectional study included 297 nonpregnant women with abnormal cervical cytology and no prior treatment for cervical dysplasia or cancer. All women underwent gynecological examination, colposcopy, endocervical curettage, and had cervical biopsies taken. Colposcopy was considered satisfactory if the squamocolumnar junction was fully visible, and biopsies were taken from all four quadrants of the cervix, regardless of colposcopy results.

Results: In all, 130 of the women in our study had satisfactory colposcopy results and were diagnosed with cervical intraepithelial neoplasia grade 2 or worse (CIN2+), 61% via a colposcopy-positive biopsy and 39% via a colposcopy-negative biopsy. Eighty-seven of them had positive colposcopy results, but CIN2+ was histologically verified from colposcopy-positive biopsies in 91% (n = 79) and from colposcopy-negative biopsies in 9% (n = 8). The remaining 43 women with CIN2+ had negative colposcopy findings, so their diagnosis was verified in colposcopy-negative biopsies. The sensitivity of colposcopy alone to detect CIN2+ was 61% (95% CI 52-69).

Conclusions: In the present study, colposcopy was not a stand-alone diagnostic method. Colposcopy-negative biopsies had a clear additive value, identifying a substantial proportion of women with both positive and negative colposcopy results with treatment-worthy cervical dysplasia. Endocervical curettage material had little diagnostic value in this study.

Keywords: Additional biopsy; cervical intra-epithelial neoplasia; colposcopy; colposcopy-negative biopsies; colposcopy-positive biopsies; endocervical curettage.

PubMed Disclaimer

References

    1. Reid R, Scalzi P. Genital warts and cervical cancer. VII. An improved colposcopic index for differentiating benign papillomaviral infections from high‐grade cervical intraepithelial neoplasia. Am J Obstet Gynecol. 1985;153:611–8. - PubMed
    1. Bornstein J, Bentley J, Bosze P, Girardi F, Haefner H, Menton M, et al. 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy. Obstet Gynecol. 2012;120:166–72. - PubMed
    1. Strander B, Ellstrom‐Andersson A, Franzen S, Milsom I, Radberg T. The performance of a new scoring system for colposcopy in detecting high‐grade dysplasia in the uterine cervix. Acta Obstet Gynecol Scand. 2005;84:1013–7. - PubMed
    1. Stoler MH, Vichnin MD, Ferenczy A, Ferris DG, Perez G, Paavonen J, et al. The accuracy of colposcopic biopsy: analyses from the placebo arm of the Gardasil clinical trials. Int J Cancer. 2011;128:1354–62. - PubMed
    1. Gage JC, Hanson VW, Abbey K, Dippery S, Gardner S, Kubota J, et al. Number of cervical biopsies and sensitivity of colposcopy. Obstet Gynecol. 2006;108:264–72. - PubMed

Publication types