In this study, we aimed to evaluate the Pap-smear results and colposcopic findings of 163 patients admitted to the colposcopy unit of our hospital with the histopathological examination results of cervical sampling for abnormal Pap-smear and/or colposcopy findings in the absence of HPV test. All patients underwent gynaecological examination, and Pap-smear test was performed. Subsequently, the cervix was examined by colposcopy. Local medical treatment, Pap-smear follow up, cervical sampling or surgery was recommended according to Pap-smear, colposcopic examination results and other clinical examination findings. Negative predictive value (NPV), positive predictive value (PPV), sensitivity and specificity of Pap-smear were 88.1%, 13.3%, 28.5% and 74%, respectively. NPV, PPV, sensitivity and specificity of colposcopy were 93.3%, 14.3%, 85.7 and 76.2%, respectively. The combined use of Pap-smear and colposcopy in the detection of premalignant and malignant lesions of the cervix increases the success and enables early diagnosis and appropriate treatment in the absence of HPV test.
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Tsikouras P, Zervoudis S, Manav B, et al. Cervical cancer: screening, diagnosis and staging. J BUON 2016; 21: 320-325.
Basu P, Taghavi K, Hu SY, Mogri S, Joshi S. Management of cervical premalignant lesions. Curr Probl Cancer 2018; 42: 129-136.
Smith RA, Andrews KS, Brooks D, et al. Cancer screening in the United States, 2017: A review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin 2017; 67: 100-121.
Nayar R, Wilbur DC. The Pap test and Bethesda 2014. Cancer Cytopathol 2015; 123: 271-281.
Chase DM, Kalouyan M, DiSaia PJ. Colposcopy to evaluate abnormal cervical cytology in 2008. Am J Obstet Gynecol 2009; 200: 472-480.
Trimble CL, Genkinger JM, Burke AE, et al. Active and passive cigarette smoking and the risk of cervical neoplasia. Obstet Gynecol 2005; 105: 174-181.
Insinga RP, Glass AG, Rush BB. Diagnoses and outcomes in cervical cancer screening: a population-based study. Am J Obstet Gynecol 2004; 191: 105-113.
Cheng JX, Yao LL, Xiang H, et al. Cervical cytology ASCUS patients with HPV detection and clinical value. Clin Exp Obstet Gynecol 2016; 43: 592-596.
Bornstein J, Bentley J, Bösze P, et al. 2011 colposcopic terminology of the International Federation for Cervical Patholgy and Colposcopy. Obstet Gynecol 2012; 120: 166-172.
MacLean AB. Acetowhite epithelium. Gynecol Oncol 2004; 95: 691-694.
Jahic M, Jahic E. Diagnostic Approach to Patients with Atypical Squamous Cells of Undetermined Significance Cytologic Findings on Cervix. Med Arch 2016; 70: 296-298.
Yang M, Zachariah S. ASCUS on cervical cytologic smears. Clinical significance. J Reprod Med 1997; 42: 329-331.
Rojsangruang S. Prevalence of Abnormal Cervical Cytology based on the Bethesda System, at Phetchabun Hospital. J Health Sci 2006; 15: 67-74.
Sankaranarayanan R, Thara S, Sharma A, et al. Accuracy of conventional cytology: results from a multicentre screening study in India. J Med Screen 2004; 11: 77-84.
Fahey MT, Irwig L, Macaskill P. Meta-analysis of Pap test accuracy. Am J Epidemiol 1995; 141: 680-689.
Ghaemmaghami F, Behtash N, Modares Gilani M, Mousavi A, Marjani M, Moghimi R. Visual inspection with acetic acid as a feasible screening test for cervical neoplasia in Iran. Int J Gynecol Cancer 2004; 14: 465-469.
Rieck GC, Bhaumik J, Beer HR, Leeson SC. Repeating cytology at initial colposcopy does not improve detection of high-grade abnormalities: a retrospective cohort study of 6595 women. Gynecol Oncol 2006; 101: 28-33.
Taylor RR, Guerrieri JP, Nash JD, Henry MR, O'Connor DM. Atypical cervical cytology. Colposcopic follow-up using the Bethesda System. J Reprod Med 1993; 38: 443-447.
Kohli M, Ferko N, Martin A, et al. Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK. Br J Cancer 2007; 96: 143-150.
Živadinović R, Radović M, Lilić V, Petrić S. Grading the severity of preinvasive changes of the uterine cervix by colposcopy and exfoliating cytology. FACTA UNIVERSITATIS: Medicine and Biology 2005; 12: 55-59.
Wu S, Meng L, Wang S, Ma D. A comparison of four screening methods for cervical neoplasia. Int J Gynaecol Obstet 2005; 91: 189-193.