title: Independent clinical factors which correlate with failures in diagnosing early cervical cancer.
abstract: Our aim was to identify independent factors that correlated with colposcopically directed biopsy's reliability as a method for diagnosing early cervical cancer. One hundred ninety-one of a total of 2265 patients who had colposcopic examinations because of abnormal Papanicolaou smears were included in this study. These patients had all undergone a hysterectomy after being diagnosed as having cervical intraepithelial neoplasia grade III by colposcopically directed biopsy. By univariate analysis, old age (P = 0.0195), achievement of menopausal status (P = 0.0046), large lesion size (P = 0.0021), and unsatisfactory colposcopy (P = 0.0017) were found to be associated with the nondiagnosis of early cervical cancer. However, multivariate analysis using stepwise logistic regression revealed that large lesion size (P = 0.003) and unsatisfactory colposcopy (P = 0.0008) were the only independent factors that correlated with nondiagnosis. Our findings indicate that in order to reach a clear-cut diagnosis, cases with either unsatisfactory colposcopy or satisfactory colposcopy with large lesions (despite a lack of histologic evidence of invasions) should undergo a diagnostic conization.
authors.affiliation: Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei.
authors.forename: R J
authors.initials: RJ
authors.lastname: Chen
authors.forename: D Y
authors.initials: DY
authors.lastname: Chang
authors.forename: M L
authors.initials: ML
authors.lastname: Yen
authors.forename: E F
authors.initials: EF
authors.lastname: Lee
authors.forename: S N
authors.initials: SN
authors.lastname: Chow
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
authors.forename: C Y
authors.initials: CY
authors.lastname: Hsieh
mesh_terms: D000328:Adult; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology*