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Video monitoring of smear-taking at colposcopy: relationship to cytology
Article first published online: 23 AUG 2004
DOI: 10.1111/j.1471-0528.2004.00231.x
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 111, Issue 9, pages 967–973, September 2004
Additional Information
How to Cite
Al-Awadhi, R. M., Mansell, E., Chong, S., Chow, C., Singer, A. and Coleman, D. V. (2004), Video monitoring of smear-taking at colposcopy: relationship to cytology. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 967–973. doi: 10.1111/j.1471-0528.2004.00231.x
Publication History
- Issue published online: 23 AUG 2004
- Article first published online: 23 AUG 2004
- Abstract
- Article
- References
- Cited By
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.