Accuracy of Digital Colposcopy in Diagnosis of Cervical Pathology

Abstract

Background: Digital colposcopy is a novel diagnostic approach that offers enhanced visualization and documentation of cervical abnormalities compared to traditional colposcopy. The conventional methods for diagnosing cervical pathology, including Pap smear (cytology) and classic histopathological examination of excised cervix have been the standard techniques for decades. This study aimed to evaluate the usefulness and accuracy of digital colposcopy as a comparable tool to the conventional pap smear (cytology) and the classic histopathological examination. Methods: This cross-sectional study was carried out on 77 sexually active women, aged 20 to 65 years, presenting with chronic leucorrhoea, post-coital bleeding/spotting, or intermenstrual bleeding/spotting. All participants underwent comprehensive assessments, including history taking, general and abdominal examinations and pelvic ultrasound. Pap smears were collected from the ectocervix and endocervix, while digital colposcopy utilizing equipment categorized colposcopic findings as "normal," "abnormal", or "miscellaneous". Digital colposcopy-directed biopsies were conducted for major findings or suspicious for invasion cases. Results : The digital colposcope demonstrated 76.9% sensitivity and a 72%specificity for detecting the condition according to histopathology. The PPV was 85.1%, and the NPV was 60%, resulting in an overall accuracy of 75.3%. On the other hand, the PAP smear exhibited higher performance with a sensitivity of 98.1% and a specificity of 84%. The PPV for the PAP smear was 92.7%, and the NPV was 95.5%, leading to an overall accuracy of 93.5%. Conclusion: Digital colposcopy holds promise as a valuable adjunct to conventional screening methods, such as the Pap smear, in diagnosing cervical pathology