ISSN:
1471-0528
Source:
Blackwell Publishing Journal Backfiles 1879-2005
Topics:
Medicine
Notes:
Objective To investigate the reasons why cervical smears occasionally fail to reflect the underlying pathology in the cervix even when the smear is taken at colposcopy.Design A randomised study of three different smear-taking devices.Setting A colposcopy clinic.Population Women attending the colposcopy clinic.Methods A smear was taken from 172 nulliparous and 100 multiparous women at colposcopy and the procedure was monitored on a video-imaging system. The cytological findings were compared with the biopsy report in 147 nulliparous and 85 multiparous women.Main outcome measures Accuracy of cytology and the effect of a range of variables on the accuracy of cytology.Results Sampling of the transformation zone was incomplete in 15% of nulliparous women and 8% of multiparous women. Univariate analysis of a range of variables including parity, type of sampling devices, completeness of sampling of the transformation zone, size of the transformation zone, size of the lesion (aceto-white area) and location of the squamo-columnar junction showed that the accuracy of cytology was influenced by all these factors except for parity and smear-taking devices. Multivariate analysis showed that the location of the squamo-columnar junction, the size of the transformation zone area, the size of the aceto-white area and the ratio of the aceto-white area to the area of the transformation zone influenced the accuracy of cytology.Conclusions Women with large transformation zone areas (〉30.03 mm2) and/or small aceto-white lesions (〈7.01 mm2) are more likely to have an inaccurate cytology reports than women with small transformation zone and women with larger aceto-white areas. A ratio of the aceto-white area to the area of the transformation zone of 0.22 or less increases the risk of disagreement between the cytological and histological findings.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1111/j.1471-0528.2004.00231.x
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