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524 Negative predictive value of PAP smear in patients with leukoplakia patterns on colposcopy
  1. J Milojevic1,1,
  2. V Krsic2 and
  3. B Jocic Pivac2
  1. 1General Hospital Lazarevac, obgyn, Belgrade, Serbia
  2. 2GAK Narodni front, obgyn, Belgrade, Serbia



The incidence rate for cervical cancer in Serbia is twice as high as in western European countries. In our daily practice we use cervical cytology and colposcopy as a routine screening method for cervical dysplasia and cervical cancer. HVP screening is not cover by insurance and large number of poorly complaint patients limited our resources and we warrant cervical biopsy in patients with leukoplakia on colposcopy examination regardless of the Pap smear results.

Methodology This was retrospective study evaluating 398 patients with leukoplakia abnormality on colposcopy who underwent cervical biopsy between January 2010 till January 2020 in General hospital Lazarevac, obgyn department.

We correlated results of conventional cervical cytology with results of biopsy to calculate predictive value of cervical cytology in excluding the diagnosis as cervical dysplasia and cervical cancer.

Result(s)*Biopsy results showed 92 patients with LGSIL, 35 with HGSIL, and 1 with invasive carcinoma of cervix. Normal finding on biopsy had 270 patients.

Normal Pap smear had 350 patients and 48 patients had some of cervical abnormality. Negative predictive value (NPV) of Pap smear for excluding severity dysplasia and cervical cancer was 97,39%.

NPV for excluding any type of dysplasia in patients with leukoplakia was 74,86%. Positive predictive value (PPV) of abnormal cytology was 86,79% for discover abnormal findings on cervical biopsy.

Conclusion*Pap smear is useful tool to guide necessity for cervical biopsy in patients with leukoplakia pattern on colposcopy. High negative predictive value in our study show us that cervical biopsy can be avoided in patients with leukoplakia and normal Pap smear.

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