Improved cervical cancer screening in premenopausal women by combination of Pap smear and speculoscopy

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• 作者：Nae-Fang Twu ; Yi-Jen Chen ; Peng-Hui Wang ; Bill Ken-Jen Yu ; Chung-Ru Lai ; Kuan-Chong Chao ; Chiou-Chung Yuan ; Ming-Shyen Yen
• 关键词：Cervical cancer screening ; Papanicolaou smear ; Speculoscopy ; PapSure examination
• 刊名：European Journal of Obstetrics and Gynecology and Reproductive Biology
• 出版年：2007
• 出版时间：July 2007
• 年：2007
• 卷：133
• 期：1
• 页码：114-118
• 全文大小：125 K

文摘

This study was done to evaluate the efficacy of the Pap smear, speculoscopy, and a combination of Pap smear and speculoscopy (PapSure examination) in pre- and postmenopausal women.

Study design

All women were screened using the Pap smear and speculoscopy and combination of both (PapSure examination) in the multicenter trial. Final diagnosis of each patient was based on a histological evaluation of the colposcopic target biopsy. Results were analyzed using a proportional comparison test, sensitivity, specificity, and predictive value with significance determined at p < 0.05.

Results

Of 1813 women screened, 1701 were eligible for analysis. Two hundred and fourteen women (12.6 % ) received at least one positive screening test result. Of the 1084 colposcopic biopsy specimens obtained, 24 showed low-grade squamous intraepithelial lesion (LSIL) and 19 high-grade SIL (HSIL). HSIL were considered test-positive. Rate of colposcopy was 21.5 % (125/582) in the premenopausal group and 63.9 % (321/502) in the postmenopausal group (p < 0.001). For premenopausal women, speculoscopy (75.0 % ) or PapSure (91.7 % ) provided higher sensitivity than Pap smear (50 % ) (p < 0.05). In postmenopausal women, no statistical significance in sensitivity existed between PapSure (85.7 % ) and Pap smear (57.1 % ). Speculoscopy (96.8 % ) or PapSure (96.5 % ) had lower specificity than Pap smear (99.6 % ) (p < 0.001).

Conclusion

PapSure was an accurate alternative screening method to Pap smear or speculoscopy for cervical intraepithelial lesions because of a significantly higher sensitivity along with adequate specificity for premenopausal women; however, PapSure was not a more effective cervical screening method for postmenopausal women.