Accuracy of colposcopic findings in detecting vaginal intraepithelial neoplasia: a retrospective study

Purpose Malignancies in the vagina are rare, and colposcopy-directed biopsies play a major role in detecting vaginal intraepithelial lesions. The aim of this study was to evaluate the accuracy of colposcopy-directed biopsy in comparison with examiners’ clinical findings.

Methods The accuracy of colposcopy-directed biopsy was compared with the clinical findings in relation to the patients’ age and the examiners’ level of training. The data were collected between January 2014 and February 2018 at the certified Dysplasia Unit.

Results A total of 253 vaginal biopsies were obtained from 253 women. The overall accuracy of biopsy in comparison with the clinical findings was 52.17 % for all entities. The accuracy for detecting HSIL was 82.46 % (47/57), with an underdiagnosis rate of 15.79 % and an overdiagnosis rate of 1.79 %.

Conclusions With a sensitivity of over 80 %, colposcopy-directed biopsy plays an important role in detecting vaginal HSIL. Careful examination is required in women with a history of HSIL in the lower genital tract or with simultaneous neoplasia, as they are at greater risk of developing vaginal malignancies. A combination of careful clinical work-up, Pap smear, HPV testing, and colposcopy-guided biopsy is crucial for detecting vaginal HSIL.

Publication History

Article published online:
07 October 2020