Diagnostic value of Pap smear compared with colposcopy in diagnosis of abnormal cases in women referred to gynecology clinic

Document Type : Original Article


1 Instructor, Department of Midwifery, School of Nursing and Midwifery, Yasouj University of Medical Sciences, Yasouj, Iran.

2 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran University, Tehran, Iran.

3 M.Sc. in Nursing, School of Nursing and Midwifery, Yasouj University of Medical Sciences, Yasouj, Iran.

4 Gynecologist, Fellowship of Oncology, Faculty of Medicine, Tehran University, Tehran, Iran.


Introduction: Cervical cancer is the third most common cancer in women, and its annual incidence is more than 500,000 cases in the world and is the most common cause of death due to gynecologic cancer in America in 2011. The pursuit of abnormal Pap smear with the help of high-sensitivity diagnostic methods requires to evaluate the diagnostic value of Pap smear compared with colposcopy in diagnosing the abnormal cases and timely treatment and reduce the mortality from cervical cancer. Therefore, this study was performed with aim to evaluate the diagnostic value of Pap smear compared with colposcopy in diagnosing the abnormal cases of cervix.
Methods: This cross-sectional descriptive study was performed on 172 women with abnormal Pap smear who referred to the gynecology clinic of Yasouj and had undergone colposcopy in 2015. Data collection tools included a checklist (demographic and midwifery characteristics, Pap-smear report and colposcopic examination), and data collection method was through examination and observation. Data were analyzed by SPSS software (version 19) and Chi-square test. P<0.05 was considered significant.
Results: In this study, 55 patients (31%) had abnormal colposcopy and 22.1% of abnormal cases were aceto withe. 117 cases (68.0%) of abnormal pap smears were diagnosed by normal colposcopy, which indicated the compliance of pap smear and colposcopy with an agreement coefficient of 30% (p = 0.032). The most compliance of pap smear and colposcopy was obtained in a high-grade lesion (CIN3), and the least complication was reported in cases which pap smear showed a mild-grade lesions (CIN1, CIN2). The diagnostic sensitivity of colposcopy was obtained 93%, so the diagnostic accuracy of colposcopy (54.3%) was higher than pap smear (41.26%).
Conclusion: Colposcopy compared with Pap smear has higher efficacy and diagnostic accuracy in finding the early stages of cervical cancer. The most compliance of pap smear and colposcopy was obtained in a high-grade lesion (CIN3). 


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