Analytical study of symptoms and various screening modalities in cervical cancer

Abstract

Cervical cancer is preceded by a long phase of premalignant cytological changes that takes over a period of 15-20 years for the invasive cancer to develop. Thus, cervical cancer can be prevented, if cellular changes are detected and treated at an early stage.Lack of resources, lack of awareness, lack of effective screening programs and poorly organized health system seem to be the reasons for higher prevalence of cervical cancer in India & other developing countries.

AIM:To evaluate symptoms andto Compare Pap smear & Colposcopy with Cervical Biopsy Histopathology in evaluation of women with abnormal cervical cytology.

OBJECTIVES: To screen symptomatic women and asymptomatic women with unhealthy cervix with Pap smear. To perform Colposcopic evaluation of the cervix for women with abnormal cytology and have Colposcopic directed biopsy. To compare various screening modalities used.

METHODOLOGY:All patients with inclusion criteria in OBG Department of Teerthanker Mahaveer Medical College & Research Center during period of January 2017 to June 2018.After taking thorough history, they were subjected to different screening methods.

RESULTS: The commonest presenting symptom was vaginal discharge (79% of the patients). The sensitivity of PAP smear is 44.8% and the specificity is 92.9%. The Positive Predictive Value of PAP Smear is 72.2% and the Negative Predictive Value is 80.4%. The Accuracy of PAP Smear is 79%. While the Sensitivity of Colposcopy is 86.2% and the Specificity is 81.6%. The positive predictive value is 65.7% and the negative predictive value is 93.5%. The Accuracy of Colposcopy is 83%.

CONCLUSION: Colposcopy with directed biopsy should be the standard of evaluation and management of symptomatic patients with unhealthy cervix, described as the 'gold standard' for the diagnosis of Precancerous cervical lesions. The sensitivity of Pap smear was poor but it had better specificity. Hence it may be better to utilize both tests as they complement each other in screening of precancerous lesions.