Agreement Between Colposcopy And Cervical Biopsy

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Agreement Test of Documentation of Visual Inspection with Acetic Acid DoVIA and Colposcopy findings as a Screening Tool for Cervical Cancer

Agreement Test of Documentation of Visual Inspection with Acetic Acid DoVIA and Colposcopy findings as a Screening Tool for Cervical Cancer

and can be done at the level of health services with limited facilities. 8 Looking on its benefi t of VIA as an alternative screening, the idea arises to conduct an VIA documentation examination using a cell phone camera which in principle can resemble a colposcopy based on visualization checks, and this examination is called "DoVIA", leading to the idea called Mini Colposcopy, by visual observation without a magnifying device for the detection of cervical cancer. 8-10

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A prospective randomized study on limits of colposcopy and histology: the skill of colposcopist and colposcopy-guided biopsy in diagnosis of cervical intraepithelial lesions

A prospective randomized study on limits of colposcopy and histology: the skill of colposcopist and colposcopy-guided biopsy in diagnosis of cervical intraepithelial lesions

The value of multiple or random cervical biopsies at the time of colposcopy for evaluation of an abnormal cy- tology has been discussed in the last decades. The num- ber of specimens seems to influence the sensitivity of the diagnosis on cervical biopsies. The proportion of women with CIN 2 or worse increased when multiple random cervical biopsies in quadrants without lesions were performed [27]. Zuchna C. et al. [29] showed that two biopsies achieved a highly significant improvement in agreement between punch biopsy and cone specimen in comparison to one biopsy. On the contrary, in our Table 2 Histological diagnosis of specimen A and B resulted from the routine analysis and from the revision analysis performed by an experienced gynecologic pathologist
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The correlation between colposcopy, cervical cytology and histopathology in the diagnosis and management of cervical lesions: a cross sectional study

The correlation between colposcopy, cervical cytology and histopathology in the diagnosis and management of cervical lesions: a cross sectional study

Background: The study was undertaken to see the correlation between cervical cytology, histopathology and colposcopy in the diagnosis and management of various cervical lesions. Methods: It is a cross sectional study conducted at a tertiary care hospital in Mumbai, in the department of obstetrics and gynecology from February 2007 to March 2008. A total 55 sexually active women were enrolled for the study who belonged to age group greater than 20 years with history of chronic leucorrhoea or post-coital bleeding/spotting, intermenstrual bleeding/spotting or examination findings of erosion, an unhealthy cervix, a lesion bleeding on touch or an abnormal or suspicious Papanicolaou smear. These women then underwent cytology, colposcopy and cervical biopsy.
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Comparative evaluation of colposcopy, cytology and histopathology for diagnosis of cervical lesions

Comparative evaluation of colposcopy, cytology and histopathology for diagnosis of cervical lesions

Literature recommends different methods ranging from simple cytology, colposcopy, and human papilloma virus deoxyribonucleic acid (HPV DNA) testing or even repeat cytology cytological screening is not specificity sufficient to successfully identify the women with due to various well recognised inherent limitations of cervical cytology, a percentage of high-grade lesions are missed on Pap smear. 7-11 Studies suggest a wide variation of sensitivity of Pap smear ranging from as low as 30% to 70%. 12 A prospective analytical study conducted in India in 2008 also showed lack of agreement of cytology with histopathology and the study concluded that even the patients with persistent inflammatory Pap smear can
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A comparative analysis of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopy biopsy histology as gold standard in women undergoing colposcopy in Kenyatta National Hospital

A comparative analysis of conventional Pap smear cytology, liquid based cytology and colposcopy clinical impression with colposcopy biopsy histology as gold standard in women undergoing colposcopy in Kenyatta National Hospital

awareness creation to promote early detection of cases through appropriate screening strategies. These results indicate that the three screening tests performed well and are viable alternatives for consideration as screening options in different settings based on the availability of resources and technical capacity. Even though colposcopy clinical impression has the highest agreement with colposcopy biopsy it’s a diagnostic and not a screening test, hence Liquid based cytology showed better performance as a screening test compared to conventional Pap smear. In general, there was good agreement for cytological results of repeat CPAP and LBC. We therefore suggest that for patients referred with abnormal pap smears requiring a repeat pap smear, liquid based cytology is used due to its higher specificity compared to conventional Pap smear where matters of cost are not an issue. However, due to the high cost of this new technology, in the normal population, conventional Pap smear remains the screening test of choice.
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Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China

Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China

The results of this study were based on examinations performed by a trained and well-experienced gynecologist; thus, our results are not transferable to communities without access to a trained colposcopist. Additionally, the gold standard for calculating sensi- tivity and specificity for cervical cancer screening is to have histopathology samples of cervical biopsies of all women who were screened (positive or negative). 12 However, there were not sufficient resources to biopsy all women screened, and addition- ally there are risks associated with cervical biopsy. Thus, in this study not all women were biopsied. Women who were negative by portable colposcopy examination and HPV testing were considered disease-free; thus, it is possible that there is some overestimation of sensitivity and specificity.
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Cervical cancer screening in low-resource settings: a smartphone image application as an alternative to colposcopy

Cervical cancer screening in low-resource settings: a smartphone image application as an alternative to colposcopy

As a consequence of the prohibitive cost of colposcopes (US$10,000–$20,000), VIA is performed with a simple headlamp in most resource-limited settings. 14 Nevertheless, the performance of naked eye VIA as a CC screening tool is far from optimal. Such limitation translates into high screen positivity rates that are likely due to inadequate training and that inevitably lead to high overtreatment rates. By providing an efficient and practical quality control system, the smart- phone-based VIA approach circumvents the main issues that limit the naked eye VIA’s efficacy. A previous study showed that the overall agreement between the diagnoses’ quality obtained from live colposcopic visualization and static digital imaging of the cervix was 43.0% corresponding to a moderate agreement. 15 Hence, further improvement of the application is imperative in order to optimize its performance as a CC screening tool. The ultimate aim is to replace the colposcope- based pelvic examination with a smartphone-based one, thus extending CC screening to those resource-constrained areas who have no access to a standard colposcope and who are likely to suffer the most from the consequence of reduced access to health care.
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Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China

Evaluation of portable colposcopy and human papillomavirus testing for screening of cervical cancer in rural China

The results of this study were based on examinations performed by a trained and well-experienced gynecologist; thus, our results are not transferable to communities without access to a trained colposcopist. Additionally, the gold standard for calculating sensi- tivity and specificity for cervical cancer screening is to have histopathology samples of cervical biopsies of all women who were screened (positive or negative). 12 However, there were not sufficient resources to biopsy all women screened, and addition- ally there are risks associated with cervical biopsy. Thus, in this study not all women were biopsied. Women who were negative by portable colposcopy examination and HPV testing were considered disease-free; thus, it is possible that there is some overestimation of sensitivity and specificity.
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Agreement between the AMPLICOR Human Papillomavirus Test and the Hybrid Capture 2 Assay in Detection of High Risk Human Papillomavirus and Diagnosis of Biopsy Confirmed High Grade Cervical Disease

Agreement between the AMPLICOR Human Papillomavirus Test and the Hybrid Capture 2 Assay in Detection of High Risk Human Papillomavirus and Diagnosis of Biopsy Confirmed High Grade Cervical Disease

Nevertheless, when the analysis was repeated on cytology-pos- itive-only cases, results were similar to those observed for the whole series. Moreover, AMP clinical sensitivity might have been underestimated due to the retrospective study design, which excluded from analysis patients whose samples were negative by cytology and HC2, who were not referred for colposcopy but might still harbor a slight proportion of poten- tial AMP test-positive CIN2 ⫹ lesions.

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CORRELATION OF CIN CASES BETWEEN COLPOSCOPY AND COLPOSCOPY DIRECTED BIOPSY FINDINGS

CORRELATION OF CIN CASES BETWEEN COLPOSCOPY AND COLPOSCOPY DIRECTED BIOPSY FINDINGS

Cervical cancer is a deadly disease once it reaches the invasive stages but out of all the female genital tract cancers, it is the only preventable cancer if detected in its early stages. It is possible to prevent deaths due to cervical cancer through various strategies that target women >30 years for screening and treatment. [3] In a developing country like Bangladesh, cytology based screening programmes are difficult to organize because of absence of trained manpower, infrastructure, logistics;

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Role of cytology, colposcopy and biopsy in the detection of cervical intraepithelial neoplasia

Role of cytology, colposcopy and biopsy in the detection of cervical intraepithelial neoplasia

Pooja H. Khakhla*, R. Anand, Jyoti G. Sharma, Bhargav B. Boghara INTRODUCTION Cervical cancer is both preventable and curable. It has a long natural history with a prolonged pre-cancerous phase that is easily detectable and treatable. Exfoliative cervical cytology remains the mainstay for screening of pre- cancerous lesions (cervical intraepithelial neoplasia, CIN). 6,2 Assessment of women presenting with abnormal cervical cytology and the selection of those requiring treatment relies mainly on colposcopic impressions of the cervical transformation zone and histological appraisal of directed punch biopsies. There is variation in the assessment of cytology, colposcopy and histology findings, and therefore the ‘final’ diagnosis involve of all three disciplines. 5,8 The need to maximize clinical resources, achieve quicker and more effective management of patients,
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Colposcopy and Treatment of Cervical Intraepithelial Neoplasia:

Colposcopy and Treatment of Cervical Intraepithelial Neoplasia:

Cryotherapy should consist of two sequential freeze-thaw cycles, each cycle consisting of 3 minutes of freezing followed by 5 minutes of thawing (3 minutes freeze-5 minutes thaw-3 minutes freeze- thaw). The treatment time should be monitored using a stop watch. Adequate freezing has been achieved when the margin of the ice ball extends 4-5 mm past the outer edge of the cryotip. This will ensure that cryonecrosis occurs down to at least 5 mm depth. To achieve this effect evenly throughout the treatment field, it is extremely important to establish and maintain excellent contact between the probe tip and the ectocervical surface. Once the second freeze for 3 minutes is completed, allow time for adequate thawing before removing the probe from the cervix. When thawing is completed, the ice formation on the cryoprobe tip is totally cleared and the probe is removed by gently rotating on the cervix. Do not attempt to remove the probe tip from the cervix until complete thawing has occurred. After removing the probe, examine the cervix for any bleeding. The appearance of the cervix immediately after cryotherapy is shown in Figure 12.7a. Note the iceball formed in the cervix. The vagina should not be packed with gauze or cotton after cryotherapy to allow the secretions to escape. Women may be provided with a supply of sanitary pads to prevent the secretions staining their clothes.
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A Correlative
Study Between Cervical Cytology and Biopsy
Cervix.

A Correlative Study Between Cervical Cytology and Biopsy Cervix.

In the recent past, there has been emergence of various newer techniques to assess the proliferative capacity of cells. This has been an important criterion to assess the malignant behaviour of cells. Various techniques are available like DNA content analysis, ‘S’ phase fraction calculation by means of DNA cytometry, proliferating antigens like C3, F10, DNA polymerase-2, Ki67 and PCNA. But these techniques are expensive and can be carried out in some sophisticated diagnostic research centers. A simple and inexpensive method is the staining and counting of the Nucleolar Organizer Regions. This is based on RNA transcription activity. Silver colloidal solutions of high concentration have been used for this purpose and this is called AgNOR stain. The number of AgNORS in a cell nucleus reflects the proliferative activity of the cell with progressive increase in number from normal cells to dysplastic and carcinomatous cells. AgNOR in cervical cytology has also been studied. AgNOR though expensive, the single step technique and ease, which it can be done, is very impressive. Pap though less expensive than AgNOR is a cumbersome procedure with lot of chemicals involved.
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CERVICAL MEDIASTINOSCOPY WITH BIOPSY

CERVICAL MEDIASTINOSCOPY WITH BIOPSY

You should read this material and ask your surgeon(s) any questions you have before giving your consent. The Procedure: You have a condition that requires visualization (mediastinoscopy) and possible sampling (biopsy) of the lymph nodes in the center portion of your chest (mediastinum). This is performed in the evaluation of cancers, infections, and other respiratory diseases. During the procedure, a rigid tube with a light and video camera (mediastinoscope) is inserted through a small 1 inch incision just above your breastbone and passed along the outside of your airway. Your surgeon(s) will obtain one or more biopsies, which is done with a miniature device specifically made to take a small sample from the desired lymph node(s). In some cases, your surgeon(s) may also pass the mediastinoscope between some of the large blood vessels to get to specific lymph nodes generally not available during a normal examination (extended mediastinoscopy). This is particularly useful in diseases involving the left lung. The procedure can last from 15 minutes to as long as 1-2 hours, depending on the individual patient’s circumstances. The procedure requires general anesthesia and is frequently performed as an outpatient procedure.
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Detection of Cervical Infections in Colposcopy Clinic Patients

Detection of Cervical Infections in Colposcopy Clinic Patients

However, HHV-6 DNA has been detected in 88% and HHV-7 DNA has been detected in 100% of samples from the submandibular salivary gland of healthy individuals (22) sug- gesting that saliva is the important route for transmission of FIG. 2. The percentages of samples containing high-, moderate-, or low-risk HPV types with CIN 3 are shown. Within each HPV risk group, a distinction was made between the proportion of samples containing HHV-7 and those in which HHV-7 was not detected. For high-risk HPV types, the P value is 0.09; for moderate-risk HPV types, the P value is 0.016; and for low-risk HPV types, the P value is 0.3.
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Role of cytology, colposcopy and colposcopic directed biopsy in the evaluation of unhealthy cervix

Role of cytology, colposcopy and colposcopic directed biopsy in the evaluation of unhealthy cervix

Alpana Agrawal*, Amita Sharma, Manisha Gupta, Neelima Agarwal INTRODUCTION Cervical cancer is the second most common cancer among women in developing and underdeveloped countries, amounting to 80% of the global burden of this disease. 1 India bears over a tenth of the global burden of cancers. 2 As per latest data of India from GLOBOCAN 2012, top three cancers in female are breast, cervix uteri and colo-rectum. 2

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Comparative study of papanicolaou smear and colposcopy in the evaluation of cervical lesions

Comparative study of papanicolaou smear and colposcopy in the evaluation of cervical lesions

The World Health Organization global action plan on noncommunicable diseases describes screening with VIA as a tool, both highly cost-effective (i.e., it costs less than the per capita gross domestic product to avert one DALY) and feasible to implement in settings with constrained health systems. 2 There are promising results from large trials suggesting that VIA can reduce cervical cancer incidence by 25%-30%. 3,4 Although screening with HPV DNA testing is more expensive than with VIA, a study by Goldie and colleagues in five Low or Middle Income Countries (LMICs) found that HPV DNA screening is very cost-effective, and a single test at age 35 years reduces lifetime cancer risk by 25%-36%. 5,6 Integrating screening into primary care services for women should increase the likelihood that precancer is detected, as is seen in high-income countries, where effective screening averts progression to cervical cancer The present study is an endeavor to perform a comparative study of performance of colposcopy and Pap smear for mass screening of premalignant and malignant lesions of the cervix. Study aims to critically evaluate the sensitivity and specificity of Colposcopy versus Pap smear in the early detection of dysplasias. Its secondary objective being, to correlate the findings in the evaluation of unhealthy cervix by cytology, colposcopy and colposcopy guided biopsy.
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Role of Colposcopy in the Evaluation of Unhealthy Cervix and Cervical Intraepithelial Neoplasia

Role of Colposcopy in the Evaluation of Unhealthy Cervix and Cervical Intraepithelial Neoplasia

CONCLUSIONS Though Pap smear has been used as a screening method conventionally in India, studies have shown that it has low sensitivity. Moreover, there is a need of trained personnel, laboratory infrastructure, and need for compliance with follow up. Colposcopy was found to be useful in understanding the morphology of the cervical lesions, both of the benign and neoplastic, and this was very helpful in planning their management. In spite of less specificity and less positive predictive value in our study, a detailed colposcopic evaluation of cervix with a guided biopsy is an important diagnostic method for the detection of precancerous lesions and early cervical cancer. Small sample size limited the scope of further evaluation.
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A comparative study of Pap smear and colposcopy guided biopsy in the evaluation of unhealthy cervix

A comparative study of Pap smear and colposcopy guided biopsy in the evaluation of unhealthy cervix

estimated worldwide that every 5 th woman, who suffer from cervical cancer belongs to India. 5 According to WHO, 80% of death from carcinoma cervix is from developing countries. In India, carcinoma cervix plays a major role in mortality and morbidity of patient. 6 In developing countries like India, more than 70% of the population lives in rural areas. Rural Indian women undergo early marriage, multiple childbirth, poor nutrition status and they lack awareness about contraception, availability of screening programmes and therefore are prone to acquire carcinoma cervix. 7 According to a survey conducted by NFHS -2, only 50%
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Colposcopy at the University Hospital in Conakry: Role of Colposcopy in Screening and/or Diagnosis of Cervical Cancer in the UTH University Teaching Hospital of Conakry

Colposcopy at the University Hospital in Conakry: Role of Colposcopy in Screening and/or Diagnosis of Cervical Cancer in the UTH University Teaching Hospital of Conakry

DOI: 10.4236/ojog.2018.85056 498 Open Journal of Obstetrics and Gynecology 1. Introduction Cancer of the cervix is the second cancer of women in the world after the breast [1]. In developed countries, the incidence and mortality of cancer decreased considerably through systematic screening programs [2]. In Africa, on the other hand, cervical cancer mortality is about 22.5 deaths per 100,000 women per year and survival at 5 years is estimated at 21% [3]. In Guinea, cancer of the cervix is a real public health problem; it represents the first cancer of women, and the second all sex confused according to EDS Guinea 2012 [4]. Colposcopy is the screening tool commonly used in developing countries, which will also allow biopsy for the diagnosis. The objective of this work was to evaluate the role of colposcopy in screening for cancer of the cervix in the CHU of Conakry.
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