ROLE OF CYTOLOGY AND COLPOSCOPY DIRECTED BIOPSY IN EVALUATION OF CLINICALLY SUSPICIOUS CERVIX

Background: Cervical cancer is the second most common cancer among women in developing countries. Cervical cancer is a deadly disease once it reaches the invasive stages but out of all the female genital tract cancers, it is the only preventable cancer if detected in its early stages and the disease is almost 100% curable with accurate screening and early detection. Traditional screening for cervical cancer is done with papanicolaou smear test, colposcopic examination and colposcopic directed biopsy for histopathology. Obejective: To evaluate efficacy of both cytology and colposcopy directed biopsy in evaluation of clinically suspicious cervix. Patients and Methods: Cross sectional study on 300 patients with clinically suspicious cervix attending the outpatient Department of Obstetrics and Gynecology, at the Hospital of Al-Azher Assiut University. Results: Pap smear had a sensitivity of 25.5% and a specificity of 87% which was attributed to the high number of false negative smears. Accuracy of pap smear was 76.7%. Colposcopy showed a sensitivity of 82% and a specificity of 81%. Sensitivity was more than pap smear but specificity was less than pap smear. * Accuracy of colposcopy was found to be 81% which was comparatively more than that of pap smear (77%). Conclusion: It is evident that colposcopy is definitely more sensitive and accurate than pap smear. By combining pap smear with colposcopy, we can maximize the sensitivity and specificity of cancer cervix screening. Both the result of cytology and colposcopy should be compared to those of histopathology, that histopathology remain the main method of diagnosing the precursors of neoplastic cervical lesion.