title: Variability study between Pap smear, Colposcopy and Cervical Histopathology findings.
abstract: OBJECTIVE
  To determine the agreement/variability between colposcopic findings, Pap smear cytology and histopathological diagnosis in gynaecology patients.
  
  
  METHODS
  The cross-sectional cohort study was conducted from October 2010 to September 2011 at the Fauji Foundation Hospital, Rawalpindi, and comprised women who presented to the out-patient department with various gynaecological complaints. Colposcopy was performed in all women with unhealthy cervix during gynaecological examination, abnormal Pap smear report, recurrent vaginal discharge and postcoital bleeding. Pap smear was performed before colposcopy if not done earlier. Colposcopic findings were recorded on a specially-designed proforma. Biopsies from abnormal areas were taken and sent for histopathology. Colposcopic findings were compared with histopathology and Pap smear reports The agreement between the methods was evaluated by using Kappa coefficient and chi square test at a significance level of 5%.
  
  
  RESULTS
  The mean age of the 143 women was 44 8.5 years (range: 25-72 years). Colposcopic findings were normal in 66(46%) women, while 77(54%) had abnormal findings and among the latter, 62(80.5%) had abnormal histopathology, indicating strong agreement (K=0.65; p<0.001). Pap smear report was abnormal in 48(33.5%) cases and among them histopathology was abnormal in 28(58%). In the remaining 95(66.4%) patients with normal Pap smear, histopathology was abnormal in 44((46%), indicating weak agreement between Pap smear and histopathological diagnosis (K=0.10; p=0.08).
  
  
  CONCLUSIONS
  There was a strong agreement between colposcopic findings and histopathological diagnosis. However, agreement between cytological findings and colposcopic findings and cytology and histopathological diagnosis remained weak.
authors.affiliation: Department of Gynae/Obs, Foundation University Medical College, Fauji Foundation Hospital, Rawalpindi.
authors.forename: Shahida
authors.initials: S
authors.lastname: Akhter
authors.affiliation: Department of Gynae/Obs, Foundation University Medical College, Fauji Foundation Hospital, Rawalpindi.
authors.forename: Arifa
authors.initials: A
authors.lastname: Bari
authors.affiliation: Department of Gynae/Obs, Foundation University Medical College, Fauji Foundation Hospital, Rawalpindi.
authors.forename: Zartaj
authors.initials: Z
authors.lastname: Hayat
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003127:Colposcopy; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014626:Vaginal Smears
keywords: CA Cervix, Colposcopy, Correlation.