The Use of Papanicolaou Smear and Cervicography in Screening Test of Cervical Cancer

Lee, S K; Kim, S Y; Chung, H W; Lee, H H; Nam, K H; Lee, K H

Abstract

Cervicography is a rapid, technically simple screening test which involves obtaining and evaluating a photographic image of the cervix for cervical abnormalities and can be used in conjunction with Papanicolaou smear. The purpose of this study was to evaluate the screening use of cervicography as an adjunct method and compare its efficacy with that of Papanicolaou smear to identify premalignant and malignant lesion of cervix. A total of 524 subjects were screened by Pap smear, followed by cervicography who were seen in the department of Obstetrics and Gynecology, college of medicine, Soonchunhyang university from March. 7, 1996 to August. 30, 1996. Those subjects in whom abnormalities were detected by either test went through histologic examination with specimens obtained. The histologic specimens comfirmed evidence of cervical abnormality for 64 women. The results were as follows : 1. Among 64 cases, positive pathologic finding (above CINI) was in 44 cases. 2. The result of Pap smear was normal in 27 cases (42.2%) and abnormal in 37 cases (57.8%) among 64 cases. False negative rate was 27.3% (12 cases among 44 cases with positive histologic findings). False positive rate was 25% (5 cases among 20 cases with negative histologic findings). 3. Cervicographic findings were negative in 5 cases (7.8%) and positive in 57 cases (92.2%) among 64 cases. False negative rate was 2.5% (1 case among 44 cases with positive histologic findings). False positive rate was 80% (16 cases among 20 cases with negative histologic findings). 4. Sensitivity and specificity of Pap smear was 72.2%, 75% respectively. 5. Sensitivity and specificity of cervicography is 97.7%, 20% respectively. 6. Sensitivity of cervicography is significantly higher than that of Pap smear. (Sensitivity, Cervicography: 97.7%, Pap smear: 72.7%) 7. Specificity of cervicography is significantly lower than that of Pap smear (Specificity, cervicography: 20%, Pap smear: 75%) 8. Combination of both screening tests increased the sensitivity of the screening (100%). 9. Cervicography correctly detected all 22 cases of invasive cervical cancer, but Pap smear did not detect 6 cases among 22 cases. Cervicography provides excellent sensitivity and will improve the detection of cervical disease when used in conjunction with Pap smear.