title: The diagnostic accuracy of cervical biopsies in determining cervical lesions: an audit.
abstract: OBJECTIVE
  The present audit was carried out to assess the diagnostic accuracy of cervical punch biopsy during colposcopy in comparison with diagnosis from subsequent cone excision.
  
  
  METHODS
  Retrospective analysis was performed by examining the histopathology reports for paired cervical punch biopsies and cervical cone excisions for cases reported from April 2004 to March 2005 (when cervical biopsies and cones were reported by general pathologists) and from January to December 2008 (when reporting by specialist gynaecological pathologists was instituted).
  
  
  METHODS
  150 women had both cervical punch and cone biopsies performed in the 2004-2005 period, while 149 women had both biopsies performed in 2008.
  
  
  RESULTS
  In 2004-5, the rate of consistent diagnosis was 68.7%, compared with 75.8% in 2008. This was due to a decrease in the rates of overdiagnosis (16.7% vs. 14.8%) and underdiagnosis (14.7% vs. 9.4%), which was statistically significant. The sensitivity rates for 2004-5 and 2008 were 87.5% and 89.7%, and the specificity rates for the same periods were 39.8% and 39.4% respectively.
  
  
  CONCLUSIONS
  This audit highlights the importance of planning patient management on the basis of co-ordinated information from smear results, history, colposcopy findings and cervical biopsies. The introduction of specialist gynaecological histopathology reporting has significantly improved the rates of consistent diagnosis.
authors.affiliation: Department of Histopathology, Hammersmith Hospital, Imperial College London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Wang
authors.forename: M
authors.initials: M
authors.lastname: El-Bahrawy
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000601:surgery