Cervical Cytology or Colposcopy in the Identification of Cervical Intraepithelial Neoplastic Changes in Human Immunodeficiency Virus Positive Patients in an African Population?

• Published in: Indian journal of gynecologic oncology Vol. 15; no. 2
• Main Authors: Nyengidiki, T. K., Bassey, G., Sapira-Odu, L., Inimgba, N., Athanasius, B., Orazulike, N. C.
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01.06.2017
• Subjects: Medicine; Medicine & Public Health; Oncology; Original Article; Surgical Oncology; Pap test; Correlation; Sensitivity; Specificity; Colposcopy; Cervical intraepithelial neoplasia; Histology
• ISSN: 2363-8397; 2363-8400
• DOI: 10.1007/s40944-017-0114-4

Background Effective screening methods for early detection of cervical premalignant lesions among women with human immunodeficiency virus are needful since cervical cancer is one of the AIDS-defining malignancies. Aim To determine whether cervical cytology is superior to colposcopy as screening test among women infected with human immunodeficiency virus. Method A cross-sectional study was conducted at the cancer screening centre of the University of Port Harcourt Teaching Hospital from June to August 2015. Ninety-one women attending the infectious disease clinic were recruited. A pre-structured questionnaire was used to obtain information on sociodemographic characteristics. Cervical cytology, colposcopy and colposcopically directed biopsy were carried out on each patient. The data collated analysed, validity determined, and the degree of agreement of the two test screening methods was determined using Kappa statistical analysis. Results The mean age of the respondents was 36.92 ± 6.68 years with age range of 20–58 years. Among the 91 subjects analysed, the prevalence of cervical intraepithelial neoplasia was 40.7% from histological analysis. The sensitivity, specificity, positive predictive value and negative predictive value cytology were 21.62, 79.63, 42.11 and 59.72% while colposcopy had 72.97, 57.41, 54.0 and 75.61%, respectively. The Kappa value for cytology ( κ  = 0.014; p value = 0.885) as against that for colposcopy ( κ  = 0.288; p value = 0.004). Conclusion The prevalence of cervical intraepithelial neoplasia among HIV-positive women was high. Colposcopy is superior to the traditional cervical cytology as screening test for the identification of cervical intraepithelial neoplastic changes in acquired immunodeficiency-positive patients in Nigeria. There is fair degree of agreement of colposcopy  with histological diagnosis among these patients.