Clinical Usefulness of Double Combined Test (Cytology + Cervicography) for Cervical Cancer Screening

Ahn, Tae Gyu; Kim, Tae Jung; Han, Sei Jun

Abstract

OBJECTIVE
For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been concerned about the low sensitivity of cervical cytology in detection of preclinical disease of the cervix. So cervicography is introduced. In order to find out the efficacy of cytology and cervicography in early diagnosis of cervical cancer, this study included 1028 patients who visited the Department of Obstetrics and Gynecology, Cho-sun University Hospital From December 1, 1995 to March 31, 1998. And we choosed 321 samples who underwent biopsies.
METHODS
Women simultaneously underwent an exo and endo-cervical smear, and then two cervicography was obtained with applying 5% acetic acid. Because all of the subjects choosed in statistical analysis were examined by colposcopy or postoperative biopsies, the presence or abscence of disease was determined by the histologic findings.
RESULTS
1. The sensitivity and specificity of cytology was 55.4% and 86.6%. 2. The sensitivity and specificity of cervicography was 71.3% and 59.7%. 3. When cervicography and Papanicolaou smear were used conjointly, the sensitivity and specificity was 90.1% and 58.8%. 4. However the specificity of the combined test was lower than cytology alone, the sensitivity of the combined test was significantly higher.
CONCLUSION
The double combined tests of Papanicolaou smear and Cervicography were very useful in the early diagnosis of cervical neoplasia.