Concordance of PAP Smear, Colposcopy and Histopathology in Patients with Cervical Intraepithelial Neoplasia

Objective To evaluate the concordance of Pap smear, Colposcopy and histopathology in patients with cervical intraepithelial neoplasia (CIN) in a local tertiary care hospital. Design Retrospective descriptive study. Materials and methods All patient with CIN undergoing LLETZ during the period from January 2007 to July 2013 were included in the study. Case records were reviewed regarding demographics and clinical data, Pap smear reports, colposcopy findings and histopathology (HPR) reports following colposcopically directed cervical biopsy (CDB) and that following Large Loop excision of Transformation zone (LLETZ). Results patients with CIN undergoing LLETZ were included. Agreement between Pap smear and HPR was 96.2% with sensitivity of 80.6% and specificity of 60%. Agreement between CDB and HPR was 86.4% for high grade and only 33.3% for low grade lesions. Level of concordance of Pap smear with CDB was 96.2% for high grade and only 50% for low grade lesions. Main Outcome Measures Agreement between Pap smear, colposcopy, CBD and HPR. Conclusion Pap smear and CDB are complimentary to each other, and each cannot be used independently. LLETZ improves the yield of high grade lesions and detecs minimally invasive cancer which could be missed by CDB.