Modified Cervicography and Visual Inspection With Acetic Acid as an Alternative Screening Method for Cervical Precancerous Lesions

BACKGROUND: We compared the diagnostic accuracy between visual inspection with acetic acid (VIA) and modified cervicography as an alternative screening method for cervical precancerous lesions. METHODS: A diagnostic cross-sectional study was performed at the outpatient clinic at an Indonesian national referral hospital from February until April 2015. We collected samples from patients who sequentially underwent VIA examination, modified cervicography, and colposcopy. RESULTS: A total of 185 patients were included in this study. Modified cervicography showed positive results in 7.6% of patients, while 7.0% of patients had a VIA positive result. This is compared to 5.4% of patients showing abnormal colposcopy results. From those results, we obtained that sensitivity and specificity of VIA were 96.0% and 90.9%. Meanwhile, sensitivity and specificity of modified cervicography were 97.7% and 90.9%, respectively, compared to colposcopy as a gold standard. CONCLUSIONS: Modified cervicography and VIA are reliable tools for cervical cancer screening, with comparable sensitivity and specificity. Modified cervicography can be used as a supplementary tool to improve the documentation of VIA and as an alternative to VIA alone.

Development and validation of novel digitalized cervicography system

OBJECTIVE: Digital cervicography systems would be expected to reduce the costs of film cervicography, and provide the opportunity for "telemedicine-based" screening. We aimed to develop web-based digital cervicography system, and validate it compared with conventional film cervicography. METHODS: A hundred cases from five centers were prospectively included, and cervical images (analogue, digitalized by scanning analogue, and digital) were taken separately using both analogue (Cerviscope) and digital camera (Dr. Cervicam) in each patient. Nine specialists evaluated the three kinds of images of each case with time interval between evaluations of each image. To validate novel digitalized system, we analyzed intra-observer variance among evaluation results of three kinds of images. RESULTS: Sixty-three cases were finally analyzed after excluding technically defective cases that cannot be evaluable on analogue images. The generalized kappa for analogue versus digital image was 0.83, for analogue versus scanned image 0.72, and for digital versus scanned image was 0.71; all were in excellent consensus. CONCLUSION: Digitalized cervicography system can be substituted for the film cervicography very reliably, and can be used as a promising telemedicine tool for cervical cancer screening.

The comparative evaluation of clinical screening in combined tests cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II),cervicography for uterine cervical cancer / 부인종양

OBJECTIVE: Since the accuracy of Pap smear for cervical neoplasm has been questioned, a number of adjunctive tests have been developed. The purpose of this study was to evaluate which protocol is the most effective screening test among cervical cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II) and cervicography. METHODS: We chose 252 patients who were underwent the biopsy among 829 patients who visited our hospital for cervical cancer screening test. These 252 patients were engaged in this study simultaneously. They underwent triple combined test [cervical cytology (ThinPrep(R)), HPV DNA test (Hybrid capture(R) II), cervicography] and colposcopic-directed biopsy or biopsy on operation for diagnostic evaluation. RESULTS: The triple combined test showed a sensitivity of 96.0%, while double combined test [cervical cytology (ThinPrep(R))+cervicography] showed a sensitivity of 89.0%, the other double combined test [cervical cytology (ThinPrep(R))+HPV DNA test (Hybrid capture(R) II)] showed a sensitivity of 86.7%. Cervicography showed a specificity of 75.4% (highest among the single test), positive predictability of 89.8% (also highest). CONCLUSION: The sensitivity of cervical cytology was markedly improved by combination with HPV DNA test and cervicography. So the triple combined tests which improved the high false negative rate of cervical cytology may be a new effective method as a cervical cancer screening test, if the effectiveness could be confirmed by mass screening study.

Comparative analysis of conventional Papanicolaou smear, fluid-based thin-layer method and cervicography / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the diagnostic performance of Papanicolaou smear, a fluid-based thin-layer method and cervicography as a primary screening test of cervical cancer. METHODS: Among all patients screened by cervicography from January 2003 to Jun 2004, 357 patients who were examined by the Pap smear or ThinPrep Pap test and cervicography as a screening procedure for cervical cancer and taken by the subsequent colposcopy directed biopsy as required, were analyzed with a receiver operating characteristic (ROC) curves and divided into two groups: conventional Pap group (n=256) and ThinPrep group (n=101). RESULTS: ThinPrep group showed higher sensitivity (86.0%>64.0%), higher negative predictive value (78.4%>65.0%), lower false negative rate (21.6% 21.2%). Cervicography showed no significant difference between each group. In ThinPrep group, ROC curves showed the AUC of ThinPrep 0.848, the AUC of cervicography 0.585. ThinPrep group was higher with statistical significance (P=0.0001). In conventional Pap group, the result of ROC curves showed the AUC of conventional Pap 0.750, the AUC of cervicography 0.680. Conventional Pap group was somewhat higher but there was no statistical significance (P=0.0975). CONCLUSION: ThinPrep Pap test showed significantly higher diagnostic accuracy than cervicography. However, conventional Pap test revealed somewhat better screening performance than cervicography without statistical significance. Therefore, the ThinPrep Pap test might be an effective screening test in detecting precancerous lesion of the uterine cervix.

Cervicography and HPV DNA Testing as Triage Criteria for Women with Abnormal Pap Smear by Primary Care Clinicians / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to determine the predictive values of cervicography and HPV DNA test for histologic CIN diagnoses among women with abnormal cervical cytology so as to use as an intermediate triage criteria by primary care clinicians. METHODS: All 129 patients with abnormal cervical cancer screening tests underwent simultaneous or consecutive cervicography, HPV DNA test, colposcopically directed punch biopsy and/or LEEP. The results of single or combination screening tests were compared with final histopathologic findings. 71 among 129 patients were referred from other clinics, and remainders from mine between July 2000 and June 2001. RESULTS: Sensitivity/Specificity/PPV/NPV/Efficiency and FPR/FNR of single or combination tests were calculated. Following results were obtained. 1) Sensitivity : Triple combined test was 100%, double combined test by cytologic test plus either cervicography or HPV DNA test (97.8%), cytologic test (94.6%), HPV DNA test (88.4%), and cervicography (56.0%) followed. 2) Specificity : Cervicography was 61.1%, HPV DNA test (45.9%), cytologic test (30.6%), double combined test by cytologic test plus HPV DNA test (22.9%), double combined test by cytologic test plus cervicography (8.3%), and triple combined test (7.9%) followed. 3) PPV : No statistically significant differences were shown among single, double and triple combined tests, and it ranged between 72.2% and 80.8%. 4) NPV : Triple combined test was 100%, double combined test by cytologic test plus HPV DNA test (80.0%), HPV DNA test (68.0%), double combined test by cytologic test plus cervicography (60.0%), and cervicography (34.9%) followed. 5) Efficiency : Larger than 70% of efficiency in all screening methods (either single or combined) except single cervicography (57.4%). 6) FPR : Triple combined test was 92.1%, double combined test by cytologic test plus cervicography (91.7%), double combined test by cytologic test plus HPV DNA test (78.4%), cytologic test (69.4%), HPV DNA test (54.1%), and cervicography (38.9%) followed. 7) FNR : Cervicography was 44.1%, HPV DNA test (8.7%), cytologic test (5.4%), double combined test by cytologic test plus cervicography (2.2%), double combined test by cytologic test plus HPV DNA test (1.1%), and triple combined test (0%) followed. CONCLUSION: Even though the optimal clinical management of cervical cytologic abnormality remains still problematic, this study demonstrates that additional HPV DNA test and/or cervicography have much value in predicting histologic CIN diagnoses. Primary care clinicians can easily perform these tests at their clinics as an intermediate triage criteria to prevent overreferral for colposcopy without compromising the detection of significant disease underlying cytologic atypia.

Clinical Efficacy of Cervicography in Patients with Atypical Squamous Cells of Undetermined Significance (ASCUS) on Cervical Cytology / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to investigate the correlation between the cervicographic diagnoses and histologic diagnoses in patients with ASCUS cytologic diagnosis according to The Bethesda System. METHODS: This study was performed in outpatient clinic of Department of Obstetrics and Gynecology at Dankook University Medical Center from January 1, 2000 to July 31, 2000. Of the 120 patients who underwent both conventional Papanicolaou cervical cytologic test and cervicographic examination, 30 cases with ASCUS cytologic diagnosis were analyzed. Cervicographic diagnoses were compared with histologic diagnoses as a reference standard. RESULTS: Followings are the results summarized. 1. Age distribution was between 26 and 62. The mean age was 43.1 years. 2. The mean gravidity was 4.5 and the mean parity was 2.5. 3. There were 19 (63.3%) cervicographic diagnoses of Negative, 6 (20.0%) of Atypical, and 5 (16.7%) of Positive. Of the 5 Positive diagnoses, there were 3 cases of P0 and 2 cases of P1. 4. There were 1 (3.3%) histologic diagnosis of WNL, 23 (76.7%) diagnoses of cervicitis, 3 (10.0%) of LSIL, and 3 (10.0%) of HSIL. 5. Of the 19 cervicographic diagnoses of Negative, there were 17 histologic diagnoses of cervicitis, and 2 of LSIL. Of 6 cases of Atypical, there were 4 histologic diagnoses of cervicitis and 2 of HSIL. Of 5 cases of Positive, there were 3 histologic diagnoses of cervicitis, 1 of LSIL, and 1 of HSIL. 6. Cervicography for detecting LSIL or worse yielded sensitivity of 33.3%, specificity of 87.5%, positive predictive value of 40.0%, and negative predictive value of 84.0%. CONCLUSION: There was no statistical significance because of small data. Cervicography does not seem to replace conventional Papanicolaou cervical cytologic screening test or play an adjunctive role for detection of LSIL or worse in patients with ASCUS on cervical cytology. But a multicenter study with large data will be required to get the proper conclusion.

The role of cervicography in cervical cancer screening / 대한산부인과학회잡지

OBJECIVE: Although incidence of the cervical cancer has been very high, it is possible to detect the early cervical cancer with screening methods. Among the screening methods of cervical cancer, Papanicolaou smear has lower sensitivity and higher false negative rate. The goal of this study is to evaluate the usefulness of cervicography in cervical cancer screening. METHODS: The data of Papanicolaou smear and cervigram has been obtained from 292 patients. The age range varied between 20 and 78 years with the average age of 42. Histologic specimens were obtained from patients whose abnormalities were detected by either Papanicolaou smear or cervigram. A total of 101 patients received a biopsy. We calculated sensitivity, specificity, positive predictive values, negative predictive values, false negative rates and false positive rates. RESULTS: Results for Papanicolaou smear are as follows; sensitivity, 60.8%, specificity, 93.4%, positive predictive values, 66.0%, negative predictive values, 91.8%, false negative rates, 39.2% and false positive rates, 6.6%. In cervicography, sensitivity, 70.1%, specificity, 85.5%, positive predictive values, 56.3%, negative predictive values, 94.5%, false negative rates, 23.5% and false positive rates, 11.6%. Results for the combined methods are sensitivity with 82.4%, specificity with 92.5%, positive predictive values with 51.9%, negative predictive values with 97.0%, false negative rates with 11.8% and false positive rates with 16.2%. CONCLUSION: Cervicography is an effective method to screen cervical cancer. When cervicography is used with Papanicolaou smear, the detection rate of cervical cancer will be increased.

Clinical Usefulness of Double Combined Test (Cytology + Cervicography) for Cervical Cancer Screening / 대한부인종양콜포스코피학회잡지

OBJECTIVE: For many years, the Papanicolaou smear has been used to detect pre-malignant and malignant disease of the cervix. Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been concerned about the low sensitivity of cervical cytology in detection of preclinical disease of the cervix. So cervicography is introduced. In order to find out the efficacy of cytology and cervicography in early diagnosis of cervical cancer, this study included 1028 patients who visited the Department of Obstetrics and Gynecology, Cho-sun University Hospital From December 1, 1995 to March 31, 1998. And we choosed 321 samples who underwent biopsies. METHODS: Women simultaneously underwent an exo and endo-cervical smear, and then two cervicography was obtained with applying 5% acetic acid. Because all of the subjects choosed in statistical analysis were examined by colposcopy or postoperative biopsies, the presence or abscence of disease was determined by the histologic findings. RESULTS: 1. The sensitivity and specificity of cytology was 55.4% and 86.6%. 2. The sensitivity and specificity of cervicography was 71.3% and 59.7%. 3. When cervicography and Papanicolaou smear were used conjointly, the sensitivity and specificity was 90.1% and 58.8%. 4. However the specificity of the combined test was lower than cytology alone, the sensitivity of the combined test was significantly higher. CONCLUSION: The double combined tests of Papanicolaou smear and Cervicography were very useful in the early diagnosis of cervical neoplasia.

Clinical Usefulness of New Cervicography in Screening of Cervical Cancer / 대한산부인과학회잡지

OBJECTIVE: This study was performed to evaluate the usefulness of New cervicography by comparing cervicographic finding with Papanicolaou smear and result of colposcopically directed biopsy. METHODS: This study group consisted of 189 patients who visited the Department of Obstetrics and Gynecology, Chung-Ang University Pildong Hospital from September 1998 to August 1999. All women simultaneously underwent Papanicolaou smear and New cervicography. If either method was positive, the patient was referred for colposcopically directed biopsy. RESULTS: The New cervicography was significantly more sensitive than the Papanicolaou smear(92.2% vs 60.8%, p<0.01), whereas the Papanicolaou smear was significantly more specific than the New cervicography(99.3% vs 75.0%, p<0.05). The false positive rate of New cervicography was 75%, significantly higher than 0.7% of Papanicolaou smear. There was no significant difference between the negative predictive value of cervicography and Papanicolaou smear. When New cervicography and Papanicolaou smear were used together, the sensitivity was significantly higher than Papanicolaou smear used alone(98.1% vs 60.8%, p<0.01) and false negative rate was significantly lower than Papanicolaou smear(1.9% vs 39.2%, p<0.01). However the specificity, positive predictive value of the combined test were lower than Papanicolaou smear. CONCLUSION: Cervicography is one of the Papanicolaou smear adjunctive tests and a useful method to detect cervical cancer. Our study confirms the previously suspected low sensitivity of Papanicolaou smear and demonstrate that cervicography is more sensitive than Papanicolaou smear and less specific. From the above results, when New cervicography and Papanicolaou smear were used together, the detection rate of cervical cancer will be increased more easily since the cases missed by one method may be picked up by another.

Cervicography as a Screening Test for Cervical Cancer / 영남의대학술지

BACKGROUND: Uterine cervical cancer is the most common malignant tumor of the women in Korea. This study was undertaken to evaluate the usefulness of the cervicography as a screeningg test of cervical cancer. MATERIALS AND METHODS: Cervicography was taken from 482 women at department of obstetrics and gymecology, at Yeungnam University Hospital from March 1, 1998 to October 31, 1999, of the 482 women, 172women were excluded from the study for various reasons, and 310 women completed the study. Three-hundred and ten women had cervical cytology(Papanicolaou smear), cervicography and colposcopy, and punch biopsy was undertaken if any of the test result was abnormal. RESULTS: The most common age group was 35-39, and 40-44, 45-49 in order and most common reason for having a screening test was regular check for cervical cancer. The mean duration from the last Pap smear was 17.1 months, and 64 women(20.4%) never had any prior screening tests. Of the 310 women, 254 women were categorized as normal or having benign disease such as cervicitis, erosion or metaplasia. Biopsy was taken from 56 patients and the results were 26 chromic cervicitis, 4 mild dysplasia, 6 moderate dysplasia, 2 severe dysplasia, 14 carcinoma in situ and 4 invasive carcinoma. The results of cytology and cervicography were well correlated(p<0.05) The sensitivity of cytology and cervicography were 86.7% and 76.9%, respectively and the sensitivity and specificity of cervicography were 56.7% and 96.2%, respectively. False negative rate of cervicography(43.3%) was much higher than those of cytology(13.3%)(p<0.05), but false positive rate of cervicography(3.8%) was much lower than that of cytology(23.1%)(p<0.05). CONCLUSION: It seems inappropriate to use cervicography as a single scerrning test for cervival cancer, but it may be an effective complementary test for cytology to lower the false negative rate of cytology.

The Efficacy of Cervicography Combined with Pap Smear in Cervical Cancer Screening / 대한부인종양콜포스코피학회잡지

Cervicography is used commonly in cervical cancer screening with a Pap smear. Many reports shows that the combination of these two methods is more accurate and helpful in cervical cancer screening. OBJECTIVE: The purpose of this investigation was to evaluate the efficacy of conjoined methods in cervical cancer screening and to evaluate any difference between health care center and out-patient treatment. METHODS: Pap smear and cervicogram data were obtained for 699 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from January 1997 to December 1997. Of these patients, 551 patients visited the health care center and 148 were out-patients. We exmined all pertinent information, including biopsy results, for patients with detected abnormalities. A total of 62 patients received a biopsy. RESULTS: 1. Results for Papanicolaou smear were: sensitivity, 81.8%, specificity, 98.0%, positive predictive value, 83.7%, negative predictive value, 98.8%, false negative rate, 18.2%, and false positive rate, 2.0%. 2. Results for cervicography were: sensitivity, 86.4%, specificity, 97.8%, positive predictive value, 73.1%, negative predictive value, 99,1%, false negative rate, 13.6%, and false positive rate, 2.2%. 3. Results for the conjoined method were: sensitivity, 97.7%, specificity, 97.2%, positive predictive value, 70.5%, negative predictive value, 99.8%, false negative rate, 2,3%, and false positive rate, 2.8%. 4. When cervicography and Papanicolaou smear were used conjointly The sensitivity, specificity, negative predictive value, false negative rate, and false positive rate were statistically significant for Papanicolaou smear (P<0.05). 5. There was no statistical significance difference between cervicography and the conjoined method. 6. Compared with out-patients, Health care center patients showed increased diagnostic error and failure to follow-up. CONCLUSION: When cervicography and Papanicolaou smear were used conjointly, cervical cancer detection rates were increased.

Can Cervicography Play a Supportive Role in the Screening of Uterine Cervical Cancer? / 대한부인종양콜포스코피학회잡지

Despite widespread clinical acceptance and use of Papanicolaou (Pap) test, cervical cancer remains a disease of prime importance in Korea. The purpose of this study was to investigate the supportive role of cervicography in screening test for uterine cervical cancer. Pap test and cervigram data were obtained from 220 patients who visited the cancer detection center of the department of obstetrics and gynecology, Yonsei University College of Medicine from Jul.1997 to Feb.1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either Pap test or cervigram. Histologic confirmation were taken either by colposcopically directed biopsy (CDB) or large loop excision of the transformation zone (LLETZ). The results were as follows: 1. Pap test (209 cases) outcomes were WNL in 119 cases (57.0%), ASCUS in 12 cases (5.7%), LSIL in 11 cases (5.3%), HSIL in 48 cases (22.9%), and SCC in 19 cases (9.1%). 2. Cervicography (209 cases) outcomes were negative cervigram (N1, N2) in 53 cases (25.7%), benign atypia (B1, B2) in 61 cases (29.6%), suspicious atypia (S1, S2) in 59 cases (28.6%), and positive (PL, PH, PC) in 33 cases (16.1%). Technically defect (TD) in 3 cases were exclusive in analysis. 3. When cervicography and Pap test were used together, the sensi- tivity (P<0.01) and negative predictive value (P<0.01) were increased than for cervicography alone. 4. When cervicography and Pap test were used together, the sensitivity (P<0.01) and negative predictive value (P<0.05) were increased than for Pap test alone. Our study revealed that cervicography combined with Pap test improved the sensitivity and negative predictive value (NPV) in the screening of uterine cervical cancer. In conclusion, cervicography may play a supportive role in the screening of uterine cervical cancer.

The correlation of result in Cervicography, Human papilloma virus test and cervical cytology as the screening tests of cervical neoplasia / 대한부인종양콜포스코피학회잡지

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.

Can Cervicography Play a Supportive Role in the Screening of Uterine Cervical Cancer? / 대한부인종양콜포스코피학회잡지

Despite widespread clinical acceptance and use of Papanicolaou (Pap) test, cervical cancer remains a disease of prime importance in Korea. The purpose of this study was to investigate the supportive role of cervicography in screening test for uterine cervical cancer. Pap test and cervigram data were obtained from 220 patients who visited the cancer detection center of the department of obstetrics and gynecology, Yonsei University College of Medicine from Jul.1997 to Feb.1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either Pap test or cervigram. Histologic confirmation were taken either by colposcopically directed biopsy (CDB) or large loop excision of the transformation zone (LLETZ). The results were as follows: 1. Pap test (209 cases) outcomes were WNL in 119 cases (57.0%), ASCUS in 12 cases (5.7%), LSIL in 11 cases (5.3%), HSIL in 48 cases (22.9%), and SCC in 19 cases (9.1%). 2. Cervicography (209 cases) outcomes were negative cervigram (N1, N2) in 53 cases (25.7%), benign atypia (B1, B2) in 61 cases (29.6%), suspicious atypia (S1, S2) in 59 cases (28.6%), and positive (PL, PH, PC) in 33 cases (16.1%). Technically defect (TD) in 3 cases were exclusive in analysis. 3. When cervicography and Pap test were used together, the sensi- tivity (P<0.01) and negative predictive value (P<0.01) were increased than for cervicography alone. 4. When cervicography and Pap test were used together, the sensitivity (P<0.01) and negative predictive value (P<0.05) were increased than for Pap test alone. Our study revealed that cervicography combined with Pap test improved the sensitivity and negative predictive value (NPV) in the screening of uterine cervical cancer. In conclusion, cervicography may play a supportive role in the screening of uterine cervical cancer.

The correlation of result in Cervicography, Human papilloma virus test and cervical cytology as the screening tests of cervical neoplasia / 대한부인종양콜포스코피학회잡지

New Cervicography and HPV-DNA test, a adjunctive Pap Smear test, are an innovative cervical cancer surveillance system. The purpose of this study was to investigate the role of HPV-DNA test and cervicography as a pap smear in early detection of cervical cancer. Pap smear, cervicography, and HPV-DNA test data were obtained from 161 patients who visited the Department of Obstetrics and Gynecology, Chunan Hospital, Soonchunhyang University from November 1997 to April 1998. Histologic specimens were obtained from patients in whom abnormalities were detected by either pap smear or cervicogram, and by naked eye. Specimens were taken either by colposcopically directed biopsy or large loop excision of the transformation zone. Results were as follows: 1. Pap smear results were normal in 40 cases (24.8%), RCC (reactive cellular change) or ASCUS (atypical squamous cells of undetermined significance) in 74 cases (46%), and abnormal (above low grade squamous intraepithelial lesion) in 47 cases (29.2%). 2. New Cervicographic findings were negative in 93 cases (57.8%), benign or suspicious atypical in 14 cases (8.7%), and positive in 54 cases (33.5%). 3. The sensitivity (94.6% vs 67.7%, p<0.01), and the false positive rate (19.8% vs 14.6%, p<0.01) of cervicography were significantly higher than for pap smear. The specificity (83.0% vs 86.2%, p<0.01), and the false negative rate (5.4% vs 32.3%, p<0.01) of cervicography were significantly lower than for pap smear. 4. When New Cervicography and Pap smear were used together, the sensitivity was higher than for pap smear in New Cervicography used alone (p<0.01) and the specificity was lower than for pap smear or cervicography used alone (p<0.01). 5. When cervicography and pap smear and HPV-DNA test were used concurrently, the sensitivity was higher than for cervicography and pap smear used together (p<0.01), and the specificity was lower than for cervicography and pap smear used together (p<0.01). The three screening test combination is a useful interval screening method to detect cervical cancer. The detection rate of cervical cancer will be increased. Thus, we believe that cervicography and HPV testing can be important adjuntive tests for cervical cytology, final tool in precancerous cervical lesions prevention. Combination of these three tests is sensitive enough to institute "interval screening" into society.

New Cervicography in the Diagnosis of Cervical Cancer / 대한부인종양콜포스코피학회잡지

New Cervicography, a Pap smear adjunct test, is an innovative cervical cancer surveillance system. It is a relatively new technique in which a photograph of the cervix is obtained without the aid of colposcope after application of 5% acetic acid. The purpose of this study was to investigate the role of New Cervicography in diagnosis of cervical cancer. Pap smear and cervicogram data were obtained from 143 patients who visited the Department of Obstetrics and Gynecology, Chungnam National University Hospital from September 1996 to May 1997. Histologic specimens were obtained from patients in whom abnormalities were detected by either Pap smear or cervicogram. Specimens were taken either by colposcopically directed biopsy or large loop excision af the transformation zone. (continue)

The Efficacy of Cervicography in Cervical Cancer Screening / 대한산부인과학회잡지

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.

The Efficacy of Cervicography in Cervical Cancer Screening / 대한산부인과학회잡지

Cervicography is an adjunct method of cervical cancer screenign intended to complement papanicolaou smear. Cervicography involves obtaing and evalutionag a photographic image of the cervix.the purpose of this investigation was to evalute the efficacy of cervicography in cervicla cancer screening. Papanicolaou smear and cervigram data were obtainde for 169 patients who visited Department of Obstetrics and Gynecology, Chungnam Nationa University Hospital form September 1995 to march 1996. Those women in whom abnormalities were detected by either test subsequently obtained histologic specimen.the resunt wre as follows:1. the sensitivity and the specificity of cervicography was 78.8% and 86.3% respcetively. 2. the positive predictive value, negative predictive value, false negative rate, and false positive rate of cervicography were 71.9%, 90.15%, 13.7%, 21,2% respectively. 3. The sensitivity and the specifictiy of Papanicolaou smear was 84.6% and 92.3% respectivesly. 4. the positivie predictive value, negative predictive value, false negative rate, and false positive rate of Papanicoloau smear were 83.0%, 93.1%, 7.7%, 15.4% respecitively. 5. There was no significant difference between the sensitiviey and the specificity of cervicography and Papanicolaou smear (p=0.449, p=0.139) 6. When cervicography and Papanicolaou smear were used donjointly, the sensitivity was higher than for cervicography or Papanicolaou smear used alone (96.1% vs 78.8% p= 0.008, 96.1% vs 86.3%. p=0.047) However the specificity of the combined tests was lower than Papanicicolaou smear(80.3% vs 92.3% p=0.008). Cervicography is a useful method to detect cevical cancer. Howerver when cervigrams are used in conjuction with Papanicolaou smear, the detection rate of cervical cancer will be increased.