Article Text
Abstract
Introduction/Background Treatment of precancerous lesions of the cervix requires early and accurate diagnosis of the grade, location and extent of the lesion usually aided by colposcopy. However, scarcity of trained colposcopists and colposcopy centres is a big hurdle to screening programs in low middle income countries.
Methodology It was a cross sectional observational study conducted on women referred to our colposcopy clinic following an abnormal screening test. Colposcopic examination was performed by trained physicians using the mobile optical device technologies (ODT) Enhanced Visual Assessment (EVA) system and the images were saved. Cytology also performed on all the patients for comparison.The physician colposcopic impression was recorded, biopsy performed if any acetowhite lesions were found. The sensitivity, specificity, positive predictive value, negative predictive value of physician’s impression and Pap smear was compared with the final histopathological analysis
Results A total of 1000 women were screened out of which 147 were found to be screen positive. The following are the results of 147 women triaged by Mobile ODT EVA after positive first screening test .For the diagnosis of CIN1+ lesions, the Mobile ODT EVA revealed sensitivity of 86.8%[75–95],specificity of 81.9%[73–89],positive predictive value of 73.0% (60–83),negative predictive value of 91.7% (84–97) and diagnostic accuracy of 83.7%(77–89) while Pap smear is found to have sensitivity of 22.6% (12–36), specificity of 95.7% (89–99)
,positive predictive value of 75.0%( 48–93), negative predictive value of 68.7%(60–77) and diagnostic accuracy of 69.4%(61–77).
Conclusion In near future MobileODT EVA colposcopy seems to be a feasible option with good diagnostic accuracy for triaging screen positive for VIA, cytology, and HPV testing in resource limited setting.
Disclosures None.