Interobserver variability of colposcopic interpretations and consistency with final histologic results.
OBJECTIVE
To evaluate the interobserver reliability of colposcopy and the prediction of final histologic results.


METHODS
Visibility of the squamocolumnar junction, presence and grading of atypical transformation zone (ATZ), and presence and grading of cervical intraepithelial neoplasia (CIN) were assessed by nine expert colposcopists in 100 cervigrams. Pairwise kappa, group kappa, and class-specific kappa values were computed. Frequency and degree of interobserver disagreement on CIN and ATZ grading and correlation with histologic results were studied.


RESULTS
The median pairwise kappa and the group kappa values were excellent for ATZ detection, acceptable for the squamocolumnar junction, and poor for the other variables; the presence of ATZ had a sensitivity for CIN of 90.2% and a specificity of 48.6%; the colposcopic impression of high-grade CIN had a sensitivity of 54.4% and a specificity of 88%.


CONCLUSIONS
Some colposcopic predictions are reproducible between observers, predictive of the histologic results, and can be integrated in the algorithm for the management of patients with abnormal Pap smear results.
Sideri
Mario
M
European Institute of Oncology, Milano, Italy. mario.sideri@ieo.it
Spolti
Noemi
N
Spinaci
Laura
L
Sanvito
Francesca
F
Ribaldone
Raffaella
R
Surico
Nicola
N
Bucchi
Lauro
L