Cervical Cytology or Colposcopy in the Identification of Cervical Intraepithelial Neoplastic Changes in Human Immunodeficiency Virus Positive Patients in an African Population?
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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.
To determine whether cervical cytology is superior to colposcopy as screening test among women infected with human immunodeficiency virus.
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.
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).
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.
KeywordsPap test Colposcopy Histology Correlation Sensitivity Specificity Cervical intraepithelial neoplasia
Special thanks to Mr Gbarabe O, the laboratory scientist, in the department of Anatomical Pathology in the University of Port Harcourt Teaching Hospital, who processed the specimens; Matron Solomon and Mr Hart who are in charge of the colposcopy room of the cancer screening centre of the hospital and Dr Mrs Okaefor for the statistical analysis.
Compliance with Ethical Standards
Conflict of interest
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