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  • Original Article

    Colposcopic Findings and Diagnosis in Low-Income Brazilian Women with ASC-H pap Smear Results

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):178-186

    Summary

    Original Article

    Colposcopic Findings and Diagnosis in Low-Income Brazilian Women with ASC-H pap Smear Results

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):178-186

    DOI 10.1055/s-0042-1742289

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    Abstract

    Objective

    To determine the accuracy of colposcopy findings in diagnosing cervical intraepithelial neoplasia (CIN) in women with an atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) pap smear result and analyze whether the prevalence of HSIL and cancer correlates with sociodemographic risk factors and specific colposcopic findings.

    Methods

    Colposcopic findings and sociodemographic risk factors were analyzed as possible predictors of a CIN 2 or worse diagnosis in women with an ASC-H pap smear result.

    Results

    Accuracy of the colposcopic impression was 92%, sensitivity was 91.6%, and specificity was 93.1%, with a positive predictive value of 96.4% and negative predictive value of 84.3%. Diagnosis of CIN 2 or worse was more frequent in patients with a previous history of cervical dysplasia and pre-menopausal patients. Identification of major colposcopic findings, dense acetowhite epithelium, coarse mosaicism, and punctuation correlated significantly with CIN 2 or worse.

    Conclusion

    Colposcopy performed by an experienced examiner can accurately differentiate patients with CIN 1 or less from patients with CIN 2 or worse. Diagnosis of CIN 2 or worse was more frequent in patients with a previous history of cervical dysplasia and pre-menopausal patients. The degree of acetowhite changes was the best colposcopic feature to predict CIN2 or worse.

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    Colposcopic Findings and Diagnosis in Low-Income Brazilian Women with ASC-H pap Smear Results

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