Evaluation of The Sensitivity and Specificity of Colposcopy in The Early Detection of Dysplasia

Abstract

Background: Cervical cancer remains a significant public health challenge, especially in low to middle-income countries. Early detection through effective screening methods like colposcopy is crucial for timely intervention and management. Methods: This cross-sectional analytical study included 200 women attending a colposcopy center at Comilla Medical College Hospital. Participants were selected through random sampling, with inclusion criteria of women aged 20 to 60 years who were Visual Inspection with Acetic acid (VIA) positive. Result: The study primarily involved women aged 30-49 (80%), with 50% having primary education and 54% earning 3000-8000 Taka monthly. Early coitus (14-18 years) was reported by 52%, and 70% had been married for 11-20 years. High parity (>4 children) was seen in 48%, and 30% did not use contraception. Common clinical complaints included abnormal vaginal discharge (51%), post-coital bleeding (17%), and irregular P/V bleeding (12%). Colposcopy revealed cervical erosion (34%), inflammatory changes (20%), and polyps (5%). CIN-I, II, and III were detected in 12%, 2%, and 2% of cases, with biopsy confirming CIN in 9%, 4%, and 2%, and invasive carcinoma in 2%. Colposcopy showed 90.0% sensitivity, 97.1% specificity, 96.0% accuracy, 84.4% PPV, and 98.2% NPV. Conclusion: The study confirms colposcopy's effectiveness in cervical cancer screening, showing high accuracy.