ABSTRACT

To estimate the diagnostic efficacy of colposcopy & determine the strength of correlation between colposcopic impression using the Reid Colposcopic Index (RCI) and histopathology.

This was a prospective cross sectional study carried out in the colposcopy clinic at KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belgaum from January 2008 to June 2009. A total of 268 women who fulfilled the selection criteria were included in the study. All women underwent colposcopy and a diagnosis was made based on RCI. Colposcopy directed biopsy was obtained from the abnormal areas. In cases where colposcopy did not reveal any lesion, a four quadrant biopsy from the squamocolumnar junction was taken, which served as a gold standard.

Three women who had an unsatisfactory colposcopy & eleven women with the diagnosis of cervical cancer were excluded from the analysis. The sensitivity, specificity, positive predictive value & negative predictive value of colposcopy with CIN 1 as a disease threshold was 88.5%, 86.2%, 77% & 93.5% respectively. With CIN 2 as a disease threshold the sensitivity, specificity, positive predictive value & negative predictive value of colposcopy were 85.2%, 99.6%, 95.8% & 98.3% respectively. The degree of correlation between colposcopic impression using RCI & histopathology was high (k=0.73).

Colposcopy is an indispensable tool in the diagnosis of precancerous lesions & the good correlation between colposcopic impression using RCI & histopathology makes it a reproducible technique which is easy to implement in colposcopy clinics.

Keywords: colposcopy, Reid colposcopic index, cervical cancer, cervical intraepithelial neoplasia