title: Pap test accuracy and severity of squamous intraepithelial lesion.
abstract: BACKGROUND
  Cytology smears and guided biopsies are the most widely used diagnostic standards for cervical cancer (CC) screening in the developing countries.
  
  
  OBJECTIVE
  To evaluate the performance of conventional cytology in estimating the presence and grade of cervical disease against the reference standard of histopathology.
  
  
  METHODS
  After primary screening for CC, directed biopsies were performed and compared with histopathology results.
  
  
  METHODS
  Papanicolaou (Pap) smears and biopsies from 3194 women in the age group of 14-98 years were included. Cytology results were provided by doctors who performed the cervical biopsies.
  
  
  METHODS
  The accuracy of Pap smear was measured by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculated using the statistical analysis program PSPP 0.7.8.
  
  
  RESULTS
  The sensitivity of conventional cytology (Pap smear) for women with low-grade cervical intraepithelial neoplasia or less serious lesions (CIN1-) was 93% and specificity was 73%. The sensitivity and specificity of cytology for women with high-grade cervical intraepithelial neoplasia or cancer (CIN2+) was 64% and 84%, respectively.
  
  
  CONCLUSIONS
  Cytology is a sufficiently sensitive test for detection of cervical lesions and can be used as a primary testing tool to triage.
authors.affiliation: Department of Gynecology and Obstetrics, Universidade Potiguar-UnP, Natal, Brazil.
authors.forename: Rno
authors.initials: R
authors.lastname: Cobucci
authors.forename: Mjas
authors.initials: M
authors.lastname: Maisonnette
authors.forename: Ejs
authors.initials: E
authors.lastname: Macêdo
authors.forename: F C
authors.initials: FC
authors.lastname: Santos Filho
authors.forename: Pef
authors.initials: P
authors.lastname: Rodovalho
authors.forename: M M
authors.initials: MM
authors.lastname: Nóbrega
authors.forename: Aks
authors.initials: A
authors.lastname: Goncalves
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000379:methods; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000175:diagnosis* / Q000473:pathology; D055815:Young Adult