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VOLUME 5 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL ARTICLE

Role of Colposcopy in the Evaluation of Visual Inspection of Cervix with Acetic Acid-positive Cases of Unhealthy Cervix

Ferdousi Begum, Setara B Kasem, Shaikh A Razzaque, Raisa Adiba, Selma Anika

Citation Information : Begum F, Kasem SB, Razzaque SA, Adiba R, Anika S. Role of Colposcopy in the Evaluation of Visual Inspection of Cervix with Acetic Acid-positive Cases of Unhealthy Cervix. J South Asian Feder Menopause Soc 2017; 5 (2):102-106.

DOI: 10.5005/jp-journals-10032-1116

License: CC BY 3.0

Published Online: 01-07-2016

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Introduction

Cervical cancer is the second most common cancer in women worldwide, and it is the principal cancer of women in most developing countries, where 80% of cases occur. This disease is preventable by screening and treatment of preinvasive condition. All sexually active women are at risk of acquiring a human papillomavirus (HPV) infection that may lead to cervical cancer in the future. Cervical cancer is a preventable disease as the different screening, diagnostic, and therapeutic procedures are effective. The screening procedures are visual inspection of cervix with acetic acid (VIA), Pap smear, colposcopy, and HPV deoxyribonucleic acid test. Among them, colposcopy is effective in screening, taking colposcopy-directed biopsy as well as treatment of cervical intraepithelial neoplasia (CIN), such as cold coagulation, cryotherapy, and loop electro-surgical excision procedure. Hence, there is an obvious need to subject the women with VIA-positive report to colposcopy and directed biopsy. This study is done to evaluate the role of colposcopy in evaluation of VIA-positive cases.

Objective

Colposcopic evaluation of VIA-positive cases and detection of precancerous lesion of cervix for early management.

Materials and methods

This was a cross-sectional study done among married female patient aged 22 to 65 years, who had VIA-positive report, and attending the colposcopy clinic in the Department of Obstetrics and Gynecology of Sir Salimullah Medical College and Mitford Hospital from January 2014 to December 2016. Colposcopy-directed punch biopsy was taken from the abnormal colposcopic appearance and specimen sent for histopathological examination.

Results

Out of 97 cases, all had VIA-positive acetowhite areas. But colposcopy revealed that 76.29% had CIN and invasive lesions, while 23.71% had either normal or inflammatory lesions. Colposcopy-directed punch biopsy revealed that 59.79% cases had positive lesions like CIN or invasive carcinoma and 40.21% had neither CIN nor invasive lesions. Among positive lesions, about 34.02% had CIN I, 3.09% had CIN II, 0% had CIN III, and 22.68% had invasive carcinoma. In this study, sensitivity and specificity of colposcopy examination were found 94.83 and 51.28% respectively.

Conclusion

Cervical cancer presents as major cause of morbidity and mortality, especially in developing countries like Bangladesh. In developing countries, the various screening programs are implemented for its early detection and treatment. It is evident that colposcopy plays a very important role in early diagnosis and treatment of preinvasive and early invasive carcinoma of cervix. So wide use of colposcopy in screening program of Bangladesh can reduce many young women's morbidity and mortality.

How to cite this article

Kasem SB, Razzaque SA, Adiba R, Anika S, Begum F. Role of Colposcopy in the Evaluation of Visual Inspection of Cervix with Acetic Acid-positive Cases of Unhealthy Cervix. J South Asian Feder Menopause Soc 2017;5(2):102-106.


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  1. Variability study between Pap smear, colposcopy and cervical histopathology findings. J Pak Med Assoc 2015 Dec;65(12):1295-1299.
  2. Result of colposcopy among VIA positive cases attending in colposcopy clinic of BSMMU. J Med Sci Res 2014 Jan;22(1):15-22.
  3. Role of colposcopy for the detection of precancerous lesion of cervix in a medical college hospital. ICMH J 2016;7(1):15-19.
  4. Screening for cervical carcinoma by VIA. Internet J Gynecol Obstet 2012;16(2):1-5.
  5. Knowledge and awareness of cervical cancer and screening among Malaysian women who have never had a Pap smear: a qualitative study. Singapore Med J 2009 Jan;50(1):49-53.
  6. Colposcopic evaluation of the unhealthy cervix. J Clin Diagn Res 2012 Aug;6(6):1026-1028.
  7. Study of the association of human papilloma virus with cervical cancer and precancerous lesions in a group of Bangladeshi women. J Bangladesh College Physicians Surgeons 1994;12:85-88.
  8. Colposcopic findings of VIA positive gynaecological cases of BSMMU. Dissertation submitted to BCPS, 2005.
  9. Human papilloma virus and cervical cancer (Summary report), Bangladesh. Updated year 2007.
  10. Comparison and correlation of Pap smear with colposcopy and histopathology in evaluation of cervix. J Evol Med Dent Sci 2015 Jul;4(53):9236-9247.
  11. A comparison review of key epidemiological studies in cervical cancer related to current searches for transmissible agents. Cancer Res 1973 Jun;33(6):1353-1367.
  12. HPV DNA testing in cervical cancer screening. Results from women in a high-risk province of Costa Rica. JAMA 2000 Jan;283(1):87-93.
  13. ; Daly, MD. Epidemiology of cancer. In: Weiss, GR. (Ed.) Clinical oncology—a large medical book. 1st ed. San Antonio, TX: University of Texas Health Sciences Center; 1993.
  14. Epidemiology of carcinoma of the cervix in India. In: Mould, RF.; Bose, A. (Eds.) Carcinoma of the cervix in developing areas. Bristol and Philadelphia: Adam Highler; 1987.
  15. Validity of colposcopy in the diagnosis of early cervical neoplasia—a review. Afr J Reprod Health 2002 Dec;6(3):59-69.
  16. Value of colposcopy in the early diagnosis of cervical cancer in patients with abnormal Pap smears at Shahid Sadaoughi Hospital, Yazd. Asian Pacific J Cancer Prev 2011;12(12):3439-3441.
  17. Comparison of cytology, colposcopy, HPV typing and biomarker analysis in cervical neoplasia. Anticancer Res 2009 Aug;29(8):3401-3409.
  18. Grading the severity of preinvasive changes of the uterine cervix by colposcopy and exfoliating cytology. Med Biol 2005;12(1):55-59.
  19. Colposcopic evaluation of the unhealthy cervix. J Clin Diagn Res 2012 Aug;6(6):1026-1028.
  20. The role of colposcopy, colposcopically directed biopsies and cytology in the evaluation of unhealthy cervix. Indian J Basic Appl Med Res 2015 Jun;4(3):150-158.
  21. Clinical effectiveness of VIA and colposcopy based management of cervical intraepithelial neoplasia. Bangladesh Med J (Khulna) 2014;47:16-20.
  22. Worldwide burden of cervical cancer in 2008. Ann Oncol 2011 Dec;22(12):2675-2686.
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