Comparison of Portable Colposcope with Visual-based Screening and Cytology for Observational Study: Cervical Cancer Screening in a North Indian Tertiary Care Hospital: A Prospective

Abstract

Précis: Comparison of PC with other cervical cancer screening tests and determine its diagnostic accuracy in the detection of premalignant lesions of the cervix.
Objective: To determine and compare the diagnostic accuracy of the portable colposcope device with other tests of cervical cancer screening, namely the visual-based test VIA VILI and the Pap test. Also, to administer its use in outreach areas with sparse healthcare facilities.
Methods: A total of 80 women attending the Gynaecology Outpatient Department (OPD) AIIMS Rishikesh, Uttarakhand, underwent all tests of screening, namely Pap smear, visual inspection with acetic acid (VIA), visual inspection with Lugol’s iodine (VILI), and portable colposcope (PC) test, followed by standard colposcopy examination. Biopsies were taken based on standard colposcopy findings. Results of all parameters were compared according to their sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and diagnostic accuracies were calculated.
Results: Among the study participants, 34 (42.5%) were screened positive in the PAP test, 42 (52.5%) in the VIA and 37 (46.2%) in the VILI. PC identified precancerous lesions in 27 patients (33.8%). After statistical analysis, pap test had a sensitivity of 60%, a specificity 60.9%, a PPV 26.5% and an NPV was 100%. VIA had a sensitivity of 100%, a specificity 57.8%, a PPV 35.7%, and an NPV of 100%. VILI had a sensitivity of 93.3%, a specificity 64.1%, a PPV 37.8% and an NPV of 97.6%. PC had a sensitivity of 100%, specificity 81.2%, PPV 55.6% and NPV of 100% and a diagnostic accuracy of 84.8%. About 35 patients had abnormal colposcopy findings and a total of 39 biopsies were taken, including an additional 4 biopsies of patients with suspicious cervix. Histopathology (HPE) reports of 36 patients were available; 3 were loss to follow-up. PC detected all 11 patients with HPE findings of precancerous and cancerous lesions.
Conclusion: PC is comparable to other tests of screening and has shown good diagnostic accuracy.