title: Value of colposcopy in the early diagnosis of cervical cancer in patients with abnormal pap smears at Shahid Sadoughi hospital, Yazd.
abstract: OBJECTIVE
  Cervical cancer is preventable, although it is common in developing countries and Iran, where there is no defined approach to "atypical squamous cells of undetermined significance" (ASCUS) on Pap smears. This study determined the value of colposcopy in the early diagnosis of cervix cancer in females with ASCUS.
  
  
  METHODS
  This accuracy study examined 213 ASCUS cases referred from different cities from 2007 to 2009. All patients underwent a repeated conventional Pap smear, colposcopy, endocervical curettage, and a cervical biopsy, considered the gold-standard diagnostic test.
  
  
  RESULTS
  There was no significant relationship between age, age of first intercourse, smoking, or number of children and a positive cervical biopsy. The sensitivity and specificity of a repeat Pap smear for ASCUS were 15 and 93%, respectively, while the respective values for diagnosing cervical cancer with colposcopy were 80 and 80%. Endocervical curettage had 64% sensitivity and 100% specificity for diagnosing cervical cancer, and 11 positive neoplastic or malignant lesions reported on endocervical curettage were confirmed by biopsy.
  
  
  CONCLUSIONS
  Based on the low accuracy of the Pap smear in Iran as a developing country and the need for an early diagnosis of cervical cancer, a cervical biopsy and colposcopy are recommended for these patients. Colposcopy and endocervical curettage alone are better diagnostic tools than a repeat Pap smear for unsatisfactory Pap smears.
authors.affiliation: Gynecology Oncology Department, Shahid Sadoughi University of Medical Science, Yazd, Iran. drkarimi2001@yahoo.com
authors.forename: Mojgan
authors.initials: M
authors.lastname: Karimi Zarchi
authors.forename: Fariba
authors.initials: F
authors.lastname: Binesh
authors.forename: Zohre
authors.initials: Z
authors.lastname: Kazemi
authors.forename: Soraya
authors.initials: S
authors.lastname: Teimoori
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Soltani
authors.forename: Zohre
authors.initials: Z
authors.lastname: Chiti
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D060787:Neoplasm Grading; D065006:Papanicolaou Test; D011379:Prognosis; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears