Evaluation of the Sensitivity of Cervicography in a Consecutive Colposcopic Series

Abstract

Cervicography was performed in 606 women referred for colposcopy. Cervigrams were blindly reviewed by two independent readers. The positivity rate at cervicography was high (operator A = 50 %, B = 58.8 %). The sensitivity for papillomavirus infection (HPV)/cervical intraepithelial neoplasia I (CIN I) (n = 141) was 79.4 % for operator A and 80.8 % for operator B. The sensitivity for CIN II or more severe lesions (n = 22) was 95.2 % and 90.5 % for operators A and B, respectively. The positive predictive value for HPV/CIN I or CIN II, or more severe lesions was 36.9 % and 6.9 % for operator A and 32.1 % and 5.3 % for operator B, respectively. Interobserver variability was acceptable (kappa = 0.62). Cervicography suspected 27 HPV/CIN I, 1 CIN II and 1 CIN III which showed no cytologic abnormalities. This study confirms that cervicography has a good sensitivity for cervical lesions, but it is based on a selected series, not representative of a screening condition. The combination of cervicography and cytology in screening is presently under evaluation in a prospecitve study of screened women.