Pap smear, colposcopy and biopsy findings at follow-up of Pap smear positive women in North-east Thailand.
As part of an ongoing project involving a large cohort in the Khon Kaen Province in the North-east of Thailand, a total of 236 women who had tested positive for a Pap smear at the initial recruitment and advised to seek medical attention were followed up after a mean period of 3.1 years. The 204 individuals who could be contacted were interviewed to determine treatments received and underwent a further Pap smear as well as colposcopy in 179 of the cases. On clinical advice, biopsies were also taken from 32 of these. Only 15% of the total of 204 had actually received therapy, the majority undergoing surgery (self-reported). Possible positive Pap smear results were obtained for 23.5%, with 6.4% having high grade squamous intraepithelial lesions (HGSILs) or squamous cell carcinoma (SCC) (one case). Comparison of the different testing modalities demonstrated 5.6% false negatives and 16.2 false positives for the Pap smear with colposcopy as the gold standard. Compared with biopsy findings, there were 21.8% and 40.6% false positives with Pap and colposcopy, respectively, but no false negatives. The present results point to good efficacy for the initial screening, since only 0.5% of the total population developed an SCC. However, judgement as to therapy should depend on a biopsy since there were considerable false positives with the other two modalities employed.
Yuenyao
Pissamai
P
Department of Obstetrics and Gynecology, Khon Kaen University, Khon Kaen, Thailand.
Sriamporn
Supannee
S
Kritpetcharat
Onanong
O
Kaebkaew
Pilaiwan
P
Suwanrungruang
Krittika
K
Tungsrithong
Naowarat
N
Pengsaa
Prasit
P
D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy / Q000379:methods*; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening; D065006:Papanicolaou Test; D013785:Thailand / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D014626:Vaginal Smears / Q000379:methods* / Q000706:statistics & numerical data