Performance of colposcopic scoring by modified International Federation of Cervical Pathology and Colposcopy terminology for diagnosing cervical intraepithelial neoplasia in a low-resource setting

Abstract

Introduction: Colposcopy is a tool to evaluate women with cervical pre-cancer and cancer. To interpret the colposcopic findings, various scoring systems are used but with inter observer variations. To improve the quality of colposcopy, International Federation of Cervical Pathology and Colposcopy (IFCPC) has introduced a colposcopic nomenclature in 2011. Colposcopic scoring helps to select patients who need treatment for cervical intraepithelial neoplasia. Aim of the Study: The study aimed to evaluate the agreement between colposcopic diagnosis with the modified IFCPC terminology and cervical pathology in patients with abnormal screening tests and to assess the utility of this colposcopic scoring system in low resource settings. Methodology: Patients with abnormal screening tests who underwent colposcopic assessment in the department of Gynaecological oncology were included in the study. Colposcopic scoring was done by the modified IFCPC nomenclature. The results were compared with cytology and the final histopathology. Results: 56 patients were included in the study. The colposcopic scoring when compared to histopathology showed agreement in 65.7% which indicated the agreement was substantial and was statistically significant (P = 0.0001). With cytology the colposcopic score showed agreement in 35.6% indicating a fair agreement and this was also statistically significant (P = 0.001). Conclusion: Colposcopic scoring by modified IFCPC 2011 criteria showed substantial agreement with cervical histopathology. Compared to traditional methods, 2011 international terminology of colposcopy could improve colposcopic accuracy.

Key words

Cervical intraepithelial neoplasia - colposcopic scoring - colposcopy - International Federation of Cervical Pathology and Colposcopy nomenclature

Publication History

Article published online:
14 December 2020

• References

• 1 Ferlay J, Soerjomataram I, Ervik M, Forman D, Bray F, Dixit R, et al. GLOBOCAN 2012, Cancer Incidence and Mortality Worldwide in 2012. Lyon, France: International Agency for Research on Cancer; 2012.
• 2 IInstitute for Health Metrics and Evaluation. The Challenge Ahead: Progress and setbacks in breast and cervical cancer. Seattle, WA: IHME, 2011.
• 3 Sankaranarayanan R, Nessa A, Esmy PO, Dangou JM. Visual inspection methods for cervical cancer prevention. Best Pract Res Clin Obstet Gynaecol 2012;26:221-32.
• 4 Reid R, Scalzi P. Genital warts and cervical cancer. VII. An improved colposcopic index for differentiating benign papillomaviral infections from high-grade cervical intraepithelial neoplasia. Am J Obstet Gynecol 1985;153:611-8.
• 5 Ferris DG, Litaker MS; ALTS Group. Prediction of cervical histologic results using an abbreviated reid colposcopic index during ALTS. Am J Obstet Gynecol 2006;194:704-10.
• 6 Strander B, Ellström-Andersson A, Franzén S, Milsom I, Rådberg T. The performance of a new scoring system for colposcopy in detecting high-grade dysplasia in the uterine cervix. Acta Obstet Gynecol Scand 2005;84:1013-7.
• 7 Bornstein J, Bentley J, Bösze P, Girardi F, Haefner H, Menton M, et al. 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy. Obstet Gynecol 2012;120:166-72.
• 8 Li Y, Zhang H, Zheng R, Xie F, Sui L. Agreement between colposcopic diagnosis with 2011 international terminology of colposcopy and cervical pathology in cervical lesions. Zhonghua Fu Chan Ke Za Zhi 2015;50:361-6.
• 9 Tatiyachonwiphut M, Jaishuen A, Sangkarat S, Laiwejpithaya S, Wongtiraporn W, Inthasorn P, et al. Agreement between colposcopic diagnosis and cervical pathology: Siriraj hospital experience. Asian Pac J Cancer Prev 2014;15:423-6.
• 10 Benedet JL, Matisic JP, Bertrand MA. An analysis of 84244 patients from the British Columbia cytology-colposcopy program. Gynecol Oncol 2004;92:127-34.
• 11 Hammes LS, Naud P, Passos EP, Matos J, Brouwers K, Rivoire W, et al. Value of the international federation for cervical pathology and colposcopy (IFCPC) terminology in predicting cervical disease. J Low Genit Tract Dis 2007;11:158-65.
• 12 Luyten A, Buttmann-Schweiger N, Hagemann I, Scherbring S, Boehmer G, Gieseking F, et al. Utility and reproducibility of the international federation for cervical pathology and colposcopy classification of transformation zones in daily practice: A multicenter study of the German colposcopy network. J Low Genit Tract Dis 2015;19:185-8.
• 13 Cristiani P, Costa S, Schincaglia P, Garutti P, de Bianchi PS, Naldoni C, et al. An online quality assurance program for colposcopy in a population-based cervical screening setting in Italy: Results on colposcopic impression. J Low Genit Tract Dis 2014;18:309-13.
• 14 Ghosh I, Mittal S, Banerjee D, Singh P, Dasgupta S, Chatterjee S, et al. Study of accuracy of colposcopy in VIA and HPV detection-based cervical cancer screening program. Aust N Z J Obstet Gynaecol 2014;54:570-5.
• 15 Baum ME, Rader JS, Gibb RK, McAlister RP, Powell MA, Mutch DG, et al. Colposcopic accuracy of obstetrics and gynecology residents. Gynecol Oncol 2006;103:966-70.
• 16 Massad LS, Collins YC. Strength of correlations between colposcopic impression and biopsy histology. Gynecol Oncol 2003;89:424-8.