Could We Reduce Unnecessary Colposcopic Examinations?

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Banuhan Şahin
Pervin Karlı
Osman Fadıl Kara


Objective: We assessed outcomes of biopsies due to colposcopic examination because of abnormal pap smear or positive HPV test and we reviewed our approach to cervical intraepithelial lesions in the light of the literature.

Methods: This was a retrospective study involving 115 women who underwent colposcopy with positive HPV test or abnormal pap smear results in Amasya University gynecology policlinic from January 2017 to June 2018. Demographic data, colposcopy indications, HPV genotypes, cytology and biopsy results were assessed. All data were calculated with SPSS (Version 22.0, SPSS Inc., Chicago, IL, USA) for statistical analysis. Relationships between categorical variables were assessed by Fisher's Chi-square test (Fisher's Exact test). Statistical significance was accepted as p <0.05. 

Results: The median age of the colposcopy performed population was 45 (30-65 years). The rates of high risk HPV genotypes 16, 18, 16/18 and non-16/18-HPV were found to be 28.7%, 15.6%, 10.4% and 48.7%, respectively. The rates of pap-smear cytology; ASC-US, LG-SIL and HG-SIL were found to be 30.4%, 9.6% and 6.1%, respectively. The rates of colposcopic biopsy results LG-SIL and HG-SIL were found to be 20% and 9.6%. There was no relationship between the groups of HPV genotypes and pap-smear results (p>0.05). HG-SIL histopathology was frequently detected with HPV-16 genotypes. When the number of punch biopsies increased, high-grade lesions were identified greatly (p=0.01).

Conclusion: The number of unnecessary colposcopic examinations and colposcopy induced biopsies could be reduced without fear of kidnapping the diagnosis of cervical cancer.

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