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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 2/2019

01-02-2019 | Gynecologic Oncology

Accuracy of colposcopy-directed biopsy in detecting early cervical neoplasia: a retrospective study

Authors: Frederik A. Stuebs, Carla E. Schulmeyer, Grit Mehlhorn, Paul Gass, Sven Kehl, Simone K. Renner, Stefan P. Renner, Carol Geppert, Werner Adler, Arndt Hartmann, Matthias W. Beckmann, Martin C. Koch

Published in: Archives of Gynecology and Obstetrics | Issue 2/2019

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Abstract

Purpose

Colposcopy-directed biopsy is a cornerstone method for diagnosing cervical intraepithelial neoplasia. The aim of this study was to evaluate the accuracy of colposcopy-directed biopsy in comparison with definitive surgery.

Methods

The accuracy of colposcopy-directed biopsy was compared with the final histology in relation to different types of transformation zone (TZ), the patient’s age, and the examiner’s level of training.

Results

The overall accuracy of biopsy in comparison with definitive surgery was 71.9% for all entities—benign lesions, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions (HSILs), and cervical carcinoma—with an underdiagnosis rate of 11.8% and an overdiagnosis rate of 16.5%. The accuracy for detecting HSIL was 88% (401/455), with an underdiagnosis rate of 10.5% and overdiagnosis rate of 1.3%. The accuracy rates for detecting HSIL in women with TZ 1, TZ 2, or TZ 3 were 92.2, 90.5, and 76.5%, respectively. The accuracy rates for detecting HSIL in the different age groups were 93.1% (age 0–34), 83.6% (age 34–55), and 80% (age 55 or older).

Conclusions

A combination of the colposcopic findings, cytology, human papillomavirus testing, and colposcopy-directed biopsy is necessary for the correct diagnosis of HSIL. The accuracy rate depends on the TZ and the patient’s age. The examiner’s level of training does not have any substantial influence on the accuracy.
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Metadata
Title
Accuracy of colposcopy-directed biopsy in detecting early cervical neoplasia: a retrospective study
Authors
Frederik A. Stuebs
Carla E. Schulmeyer
Grit Mehlhorn
Paul Gass
Sven Kehl
Simone K. Renner
Stefan P. Renner
Carol Geppert
Werner Adler
Arndt Hartmann
Matthias W. Beckmann
Martin C. Koch
Publication date
01-02-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 2/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-018-4953-8

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