Abstract

COLCOSCOPIC EVALUATION OF THE UNHEALTHY CERVIX- A STUDY CONDUCTED ON THE POPULATION OF BIHAR

Dr. Sudhakar Singh*, Dr. Ashanka Bhardwaj, Dr. Musarrat Parveen, Dr. Supriya Singh, Dr. Rohit Singh and Dr. Jazib Nazeer

ABSTRACT

Background: The Papanicolaou’s (Pap) smear is the primary screening tool for Cervical Intra-epithelial Neoplasia (CIN) and for invasive cancer of the uterine cervix. Recently, the assumed accuracy of the Pap smear which was found to be 80% to 95% for detecting CIN and early invasive cancer, was questioned. The simultaneous use of cytological studies and screening colposcopy has been shown to increase the rate of the cervical cancer detection. Hence, there is an obvious need to subject the women with clinically unhealthy cervix to colposcopy and directed biopsy. This study is done to evaluate the role of colposcopy in detecting unhealthy cervix. Aims: To study the role of colposcopy in the evaluation of unhealthy cervix, to localize the lesions and to obtain biopsies from the selected areas. Materials and Methods: 40 patients who were aged between 30-70 years and had clinically unhealthy cervix, were subjected to a colposcopic evaluation and the findings were noted. All the patients underwent both the acetic acid and the Schiller’s test before they were subjected to colposcopic directed biopsies. The biopsies were taken from the acetowhite areas and the iodine negative areas. Results: Out of the 40 patients, 10 (26.25%) had normal colposcopic findings. The colposcopic evaluation and the guided biopy were successful in detecting abnormalities in 10 out of 12 cases. The incidence of CIN 1 and CIN 2,3 was found to be 11.25% and 10% respectively.The sensitivity of colposcopy in the present study is 83.33%. Conclusions: The value of colposcopy has been recognized, mainly in the evaluation of patients with abnormal cervical smears because of their less sensitive and false negative cytologies and because of the poor compliance of the patients for follow up. It has been felt that apart from cervical smears, colposcopy should be offered as diagnostic method in all the patients with unhealthy cervix.

Keywords: Colposcopy, Cervix, Patient Evaluation.