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
. 2023 May 29;13(11):1906.
doi: 10.3390/diagnostics13111906.

Colposcopy Accuracy and Diagnostic Performance: A Quality Control and Quality Assurance Survey in Italian Tertiary-Level Teaching and Academic Institutions-The Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV)

Massimo Origoni  1 , Francesco Cantatore  1 , Francesco Sopracordevole  2 , Nicolò Clemente  2 , Arsenio Spinillo  3 , Barbara Gardella  3 , Rosa De Vincenzo  4   5 , Caterina Ricci  5 , Fabio Landoni  6 , Maria Letizia Di Meo  6 , Andrea Ciavattini  7 , Jacopo Di Giuseppe  7 , Eleonora Preti  8 , Anna Daniela Iacobone  8   9 , Carmine Carriero  10 , Miriam Dellino  10 , Massimo Capodanno  11 , Antonino Perino  12 , Cesare Miglioli  13 , Luca Insolia  13 , Maggiorino Barbero  14 , Massimo Candiani  1
Affiliations

Colposcopy Accuracy and Diagnostic Performance: A Quality Control and Quality Assurance Survey in Italian Tertiary-Level Teaching and Academic Institutions-The Italian Society of Colposcopy and Cervico-Vaginal Pathology (SICPCV)

Massimo Origoni et al. Diagnostics (Basel). .

Abstract

Quality Control (QC) and Quality Assurance (QA) principles are essential for effective cervical cancer prevention. Being a crucial diagnostic step, colposcopy's sensitivity and specificity improvements are strongly advocated worldwide since inter- and intra-observer differences are the main limiting factors. The objective of the present study was the evaluation of colposcopy accuracy through the results of a QC/QA assessment from a survey in Italian tertiary-level academic and teaching hospitals. A web-based, user-friendly platform based on 100 colposcopic digital images was forwarded to colposcopists with different levels of experience. Seventy-three participants were asked to identify colposcopic patterns, provide personal impressions, and indicate the correct clinical practice. The data were correlated with a panel of experts' evaluation and with the clinical/pathological data of the cases. Overall sensitivity and specificity with the threshold of CIN2+ accounted for 73.7% and 87.7%, respectively, with minor differences between senior and junior candidates. Identification and interpretation of colposcopic patterns showed full agreement with the experts' panel, ranging from 50% to 82%, in some instances with better results from junior colposcopists. Colposcopic impressions correlated with a 20% underestimation of CIN2+ lesions, with no differences linked to level of experience. Our results demonstrate the good diagnostic performance of colposcopy and the need for improving accuracy through QC assessments and adhesion to standard requirements and recommendations.

Keywords: CIN; QA; QC; SIL; cervical cancer prevention; colposcopy; colposcopy sensitivity; colposcopy standards; diagnostic accuracy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Fully visible SCJ—G2—biopsy indicated.
Figure 2
Figure 2
Fully visible SCJ—G2—biopsy indicated.
Figure 3
Figure 3
Fully visible SCJ—G2—biopsy indicated.
Figure 4
Figure 4
A single biopsy is indicated (correct site).
Figure 5
Figure 5
Multiple biopsies indicated (correct sites).
Figure 6
Figure 6
A single biopsy is indicated (correct site).
See this image and copyright information in PMC

References

    1. Perkins R.B., Guido R.S., Castle P.E., Chelmow D., Einstein M.H., Garcia F., Huh W.K., Kim J.J., Moscicki A., Nayar R., et al. 2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors. J. Low Genit Tract Dis. 2020;24:102–131. doi: 10.1097/LGT.0000000000000525. - DOI - PMC - PubMed
    1. Perkins R.B., Guido R.L., Saraiya M., Sawaya G.F., Wentzensen N., Schiffman M., Feldman S. Summary of Current Guidelines for Cervical Cancer Screening and Management of Abnormal Test Results: 2016–2020. J. Womens Health. (Larchmt) 2021;30:5–13. doi: 10.1089/jwh.2020.8918. - DOI - PMC - PubMed
    1. Cagle A.J., Hu S.Y., Sellors J.W., Bao Y.P., Lim J.M., Li S.M., Lewis K., Song Y., Ma J.F., Pan Q.J., et al. Use of an expanded gold standard to estimate the accuracy of colposcopy and visual inspection with acetic acid. Int. J. Cancer. 2010;126:156–161. doi: 10.1002/ijc.24719. - DOI - PubMed
    1. Massad L.S., Jeronimo J., Schiffman M., National Institutes of Health/American Society for Colposcopy and Cervical Pathology (NIH/ASCCP) Research Group Interobserver agreement in the assessment of components of colposcopic grading. Obstet. Gynecol. 2008;111:1279–1284. doi: 10.1097/AOG.0b013e31816baed1. - DOI - PubMed
    1. Gage J.C., Hanson V.W., Abbey K., Dippery S., Gardner S., Kubota J., Schiffman M., Solomon D., Jeronimo J., ASCUS LSIL Triage Study (ALTS) Group Number of cervical biopsies and sensitivity of colposcopy. Obstet. Gynecol. 2006;108:264–272. doi: 10.1097/01.AOG.0000220505.18525.85. - DOI - PubMed

LinkOut - more resources