Value of the International Federation for Cervical Pathology and Colposcopy (IFCPC) Terminology in predicting cervical disease.
OBJECTIVE
To evaluate the colposcopic accuracy according to the International Federation for Cervical Pathology and Colposcopy (IFCPC) 2002 terminology.


METHODS
A series of 3,040 women derived from a general population were screened by means of Pap smear, unaided visual inspection, and high-risk human papillomavirus testing. All colposcopic examination results with abnormal findings and with biopsy confirmation (n = 468) were recorded, reviewed by 2 blinded colposcopists according to the IFCPC nomenclature, and included in this analysis.


RESULTS
The IFCPC terminology was easily reproduced by the 2 observers with excellent interobserver agreement (kappa =.843). Colposcopy had a sensitivity of 86% and a specificity of 30.3% in distinguishing healthy cervix from that with cervical intraepithelial neoplasia (CIN)/carcinoma. In distinguishing healthy cervix/low-grade lesions (CIN 1) from that with high-grade lesions (CIN 2/3)/carcinoma, colposcopy had a sensitivity of 61.1% and a specificity of 94.4%. Colposcopic findings graded as major changes had the highest positive predictive value for detecting high-grade lesion/carcinoma. The colposcopic abnormalities within the transformation zone and large lesions were more closely related to high-grade lesion/carcinoma, whereas a sharp outer border, multiple colposcopic abnormalities, and iodine negativity were not statistically related to severe lesions.


CONCLUSIONS
Colposcopy using the new IFCPC classification is a potentially effective screening method; when used for diagnosis, a histological sampling is necessary. The categorization of major changes and minor changes is appropriate. It is important to describe the lesion localization in relation to the transformation zone and the lesion size because these characteristics are related to high-grade lesions.
Hammes
Luciano S
LS
Department of Obstetrics and Gynecology, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. hammes@cpovo.net
Naud
Paulo
P
Passos
Eduardo P
EP
Matos
Jean
J
Brouwers
Karla
K
Rivoire
Waldemar
W
Syrjänen
Kari J
KJ
D000328:Adult; D003127:Colposcopy / Q000145:classification; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D009626:Terminology as Topic; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000175:diagnosis*; D002578:Uterine Cervical Dysplasia / Q000145:classification / Q000175:diagnosis*