Cytology vs. Colposcopy: Evaluation of its performance in detecting cervical dysplasia. A single-center study of diagnostic tests.

Abstract

Introduction: The sensitivity and specificity of diagnostic tests between cytology and colposcopy in cervical dysplasia vary due to population characteristics, type of sample collection, and staff training, among others. The objective of the present study was to determine the sensitivity and specificity in diagnostic tests between cervical cytology and colposcopy as diagnostic methods for cervical dysplasia in a reference hospital center in Guayaquil-Ecuador.

Methods: The diagnostic test study was conducted at the Guasmo Sur General Hospital, Guayas-Ecuador, from February 2017 to February 2020. Records of women diagnosed with cervical lesions with cytological and colposcopic reports of possible results: atypical squamous cells of undetermined significance (ASCUS), low-grade intraepithelial lesion (LIEBG), high-grade intraepithelial lesion (LIEAG). The sample was probabilistic. Sensitivity (S), specificity (E), positive predictive value (PPV), false positives (FP), negative predictive value (NPV), false negatives (FN) and diagnostic accuracy are presented.

Results: 278 cases were admitted. There were 120 women (43.16%) from 26 to 35 years old. LIEBG cases were the most prevalent in cervical cytology 170 (61.1%). In colposcopy, cases of LIEAG were the most prevalent 144 (51.8%). Cytology had a S 77.%, E 57.6%, PPV 55%, PF 25.1%, NPV 76.9%, FN 6%. Colposcopy had a S 72.7%, E 71%, PPV 64.6%, FP 14%, NPV 78.7%, FN 12.5%.

Conclusions: The combination of different tests, such as cytology and colposcopy, together with an adequate interpretation of the results, is essential to improve the early detection of cervical cancer.