Knowledge of cytology results affects the performance of colposcopy : a crossover study

Article Article scientifique Article Knowledge of cytology results affects the performance of colposcopy : a crossover study eng 2024-03-21 2024-03-21 author Lalande Eva Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 906089 author Clarke Holly Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland. hollyisabellaclarke@gmail.com. author Undurraga Manuela Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland. 758054 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) Manuela Stefania Undurraga Malinverno author Nguyen Vu Quoc Huy Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hué, Vietnam. author Jaksic Cyril Clinical Research Center, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland. 697773 author Goffin Frederic Department of Obstetrics and Gynecology, University of Liege, Liege, Belgium. author Arbyn Marc Unit of Cancer Epidemiology, Belgian Cancer Centre, Sciensano, Brussels, Belgium.,Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, University Ghent, Ghent, Belgium. author Jeronimo Linan Jose Ramon National Cancer Institute, Bethesda, MD, USA. 858625 author Tille Jean-Christophe Diagnostic Department, Division of clinical pathology, Geneva University Hospitals, Geneva, Switzerland. 87627 author Saiji Essia Diagnostic Department, Division of clinical pathology, Geneva University Hospitals, Geneva, Switzerland. 664737 author Vassilakos Pierre Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland.,Geneva Foundation for Medical Education and Research, Geneva, Switzerland. 25351 author Petignat Patrick Gynecology Division, Department of Pediatrics, Gynecology and Obstetrics, University Hospitals of Geneva, Geneva, Switzerland. 586685 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 189 10.1186/s12905-024-03025-y 38515088 1472-6874 PMC10956238 https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-024-03025-y Objective: To determine whether knowledge of cytology affects the colposcopist's diagnostic accuracy in the identification of cervical intraepithelial neoplasia grade 2 and worse (≥ CIN2). Method: In this cross-over study, healthcare professionals interpreted colposcopy images from 80 patient cases with known histological diagnoses. For each case, 2 images taken with a colposcope were provided (native and after acetic acid application). Inclusion criteria consisted of women with a transformation zone type 1 or 2, who had both a cytological and histological diagnosis. Cases were distributed across two online surveys, one including and one omitting the cytology. A wash-out period of six weeks between surveys was implemented. Colposcopists were asked to give their diagnosis for each case as < CIN2 or ≥ CIN2 on both assessments. Statistical analysis was conducted to compare the two interpretations. Results: Knowledge of cytology significantly improved the sensitivity when interpreting colposcopic images, from 51.1% [95%CI: 39.3 to 62.8] to 63.7% [95%CI: 52.1 to 73.9] and improved the specificity from 63.5% [95%CI: 52.3 to 73.5] to 76.6% [95%CI: 67.2 to 84.0]. Sensitivity was higher by 38.6% when a high-grade cytology (ASC-H, HSIL, AGC) was communicated compared to a low-grade cytology (inflammation, ASC-US, LSIL). Specificity was higher by 31% when a low-grade cytology was communicated compared to a high-grade. Conclusions: Our data suggests that knowledge of cytology increases sensitivity and specificity for diagnosis of ≥ CIN2 lesions at colposcopy. Association between cytology and histology may have contributed to the findings. Cervical intraepithelial neoplasia (CIN) Colposcopy Cross-over studies Cytology Diagnosis Female Humans Colposcopy / methods Cross-Over Studies Cytodiagnosis Papillomaviridae Papillomavirus Infections / diagnosis Uterine Cervical Dysplasia / diagnosis Uterine Cervical Neoplasms / diagnosis Uterine Cervical Neoplasms / pathology Vaginal Smears / methods Dewey 616.07 Dewey 618 137 Département de pathologie et immunologie 21F 58 Département de pédiatrie, gynécologie et obstétrique 223 217 Centre de recherche clinique 201 false 590 Prévention du cancer du col utérin 933 BMC women's health 24 1 2cdab6b5-48e0-4e94-85e3-496bb6bbd5e4 Article (Published version) Public Article_scientifique_from_europePmc.pdf 1062539 application/pdf CC BY-4.0 259415813b7e9ed875c2a1f47e39553f2a0357c9c5dc21b4573de6a59ebd0e5e openAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Centre de recherche clinique

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Knowledge of cytology results affects the performance of colposcopy : a crossover study	BMC women's health			2024	123	174

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Lalande, Eva