“COMPARATIVE DIAGNOSTIC ACCURACY OF PAP SMEAR AND COLPOSCOPY IN UNHEALTHY CERVIX: INSIGHTS FROM NORTHEAST INDIA”.
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Keywords
Cervical Cancer, Pap smear, Colposcopy, Diagnostic Accuracy, Comparative Study
Abstract
Cervical cancer continues to be a leading contributor to cancer-related morbidity and mortality among women worldwide. Recent epidemiological trends indicate a marked increase in the prevalence of cervical premalignant lesions. Early detection and clinical management of these abnormalities are essential for preventing malignant transformation and facilitating timely therapeutic intervention. Aim: The study sought to evaluate the diagnostic accuracy of Pap smear cytology and colposcopy in comparison to histopathological examination of cervical biopsy specimens for the diagnosis of cervical lesions. Methodology: This prospective observational study involved 180 women between the ages of 21 and 65 presenting with a clinically unhealthy cervix. Each participant underwent screening through Pap smear, colposcopy, and colposcopically guided biopsy. The findings from these diagnostic methods were systematically compared and analyzed. Final diagnostic correlations for both Pap smear and colposcopy were established using histopathological examination as the gold standard. Results: The sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) were assessed and compared between two diagnostic modalities. A total of 180 patients were included in the study, with a mean age of 33.26 ± 7.29 years. The Pap smear demonstrated a sensitivity of 78.1% and a specificity of 91.2%. Its PPV and NPV were calculated as 65.8% and 95.1%, respectively. In comparison, colposcopy yielded a sensitivity of 90.6%, specificity of 94.6%, PPV of 78.4%, and NPV of 97.9%. The overall diagnostic accuracy was reported to be 88.9% for Pap smear and 93.9% for colposcopy. Conclusion: The study indicates that colposcopy exhibits superior diagnostic accuracy compared to Pap smears in identifying cervical premalignant and malignant lesions. Colposcopy and colposcopically guided biopsy should be integrated with Pap smear in cervical cancer screening, given that their combined application yields higher accuracy in identifying cervical abnormalities.
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Dr. Pijush Das
MS, Medical Officer, Tripura Sundari Sub Divisional Hospital, Udaipur (Tripura), 799120, India,
Dr. Jaharlal Baidya
MD, Professor, Department of Obstetrics and Gynaecology, Agartala Government Medical College & Govind Ballabh Pant Hospital, Agartala (Tripura), 799006, India,
Dr. Sayantan Choudhury
Senior Resident, Department of Obstetrics and Gynaecology, Agartala Government Medical College & Govind Ballabh Pant Hospital, Agartala (Tripura), 799006, India,
Dr. Kula Shekhar Bhattacharjee
Associate Professor, Department of Pathology, Agartala Government Medical College & Govind Ballabh Pant Hospital, Agartala (Tripura), 799006, India
Dr. Gopa Paul,
Senior Resident, Department of Obstetrics and Gynaecology, Agartala Government Medical College & Govind Ballabh Pant Hospital, Agartala (Tripura), 799006, India
Dr. Nishtha Das
MD Pathology, Medical Officer, Tripura Sundari Sub Divisional Hospital, Udaipur (Tripura), 799120, India
