A Multicentre Study Comparing Cervicography and Cytology in the Detection of Cervical Intraepithelial Neoplasia
| Autor: | Marc Wayembergh, Dina Hertens, Philippe Autier, Marianne Vosse, Frans Wesling, Michel Coibion, C. Bowlon, Françoise Huet, Philippe De Sutter |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Biopsy education Uterine Cervical Neoplasms Cervical intraepithelial neoplasia Sensitivity and Specificity McNemar's test Pregnancy Cytology Cancer screening Photography medicine Humans Mass Screening False Positive Reactions Prospective Studies Aged Aged 80 and over Colposcopy Gynecology medicine.diagnostic_test Obstetrics business.industry Obstetrics and Gynecology General Medicine Middle Aged Uterine Cervical Dysplasia medicine.disease Squamous intraepithelial lesion Cytopathology Female Cervicography business |
| Zdroj: | Europe PubMed Central |
| ISSN: | 0029-7828 |
| DOI: | 10.1097/00006254-199810000-00014 |
| Popis: | Objective To evaluate in a multicentre setting the performance of cervicography compared with Design Prospective comparative multicentre study. Setting Three hospitals with outpatient gynaecology clinics and three cancer screening clinics. Participants and methods Cervical cytology and cervicography were performed on 5724 women. If one or both tests showed an abnormality suggestive of at least a low grade squamous intraepithelial lesion, a colposcopy with directed biopsy was carried out. Cervicograms were evaluated by four experienced ‘senior’ assessors and by ten new ‘junior’ assessors. Results Results were fully analysed for 5192 women (9l%). A cervical biopsy was carried out on 228 women and this confirmed a true positive lesion in 116 cases (incidence rate: 2.2%). Of these, 72 cases (62.1%) were detected by cervicography and 64 (55.2%) by cytology. This difference was not statistically significant (McNemar: P= 0.475). Only 20 cases of CIN (17%) were concordantly detected by both tests. Senior assessors performed significantly better with a detection capacity of 80.6% compared to a detection capacity of 56.6% for the junior assessors (χ2 test: P= 0.034). Conclusions Cervicography must be considered as a complementary test to cytology. Overall detection of CIN is improved, but this is mainly due to the detection of more low grade lesions. The lower sensitivity and specificity in high grade lesions compared with cervical cytology is the main limitation of cervicography in screening for CIN. An important finding was that the performance of cervicography was highly dependent on the assessors’ experience. |
| Databáze: | OpenAIRE |
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