Citology versus colposcopy for the diagnosis of cervical intraepithelial neoplasia: a diagnostic precision study

Abstract

Introduction: In Honduras, cervical cancer is the second most frequent type of cancer. Objective: To evaluate the diagnostic accuracy of cervical cytology and colposcopy to detect cervical intraepithelial neoplasia (CIN). Methods: Retrospective study of diagnostic accuracy by performing review of records in patients seen between January 2019-April 2023 at the Gynecology Clinic of the Emma Romero de Callejas Cancer Center in Tegucigalpa, Honduras. We included 271 patients who had all three studies (cytology, colposcopy and biopsy, the latter considered the gold standard). Sensitivity, specificity and predictive values were estimated for each test. Results: Cytology for squamous intraepithelial lesions (SIL) showed a sensitivity (S) of 56.1% (95%CI 50 - 61.9) and a specificity (S) of 42.9% (95%CI 15.8 - 74.9), and colposcopy had S 97.7% (95%CI 95 - 98) and S 14.3% (95%CI 2 - 51). For low-grade squamous intraepithelial lesion (LSIL), cytology had S 34.7% (95%CI 28.2 - 41.2) and E 71.2% (95%CI 57.8 - 81.7), and colposcopy had S 88.1% (95%CI 83.1 - 91.8) and E 67.3% (95%CI 53.8 - 78.4). - 78.4). In high-grade squamous intraepithelial lesion (HSIL), cytology showed S 37.8% (CI95% 25.1- 52.3) and E 93.8% (CI95% 89.9 - 96.3), and colposcopy S 73.3% (CI95% 58.9 - 84.0) and E 90.7% (CI95% 86.2 - 93.9). Discussion: Colposcopy is more sensitive and cytology more specif Their combination improves accuracy in CIN, recommending their joint use.