title: Diagnostic Value of Visual Examination of Cervical Polypoid Lesions and Predictors of Misdiagnosis.
abstract: OBJECTIVE
  This study reviews occasions when cervical polyps removed in an outpatient setting proved not to be cervical polyps histologically. We aimed to identify any anatomical and/or clinical characteristics that predict 'incorrect diagnosis" in general practice.
  
  
  METHODS
  A retrospective study of consecutive 345 patients who were initially diagnosed with cervical polyps based on a routine gynecological examination in an outpatient setting was included. After histopathological examination, the patients were divided into 2 groups: those with cervical (correct diagnosis, n = 307) and falsely diagnosed with cervical polyps (FDP, n = 38). These 2 groups were compared in terms of age, signs and symptoms, and size of the polypoid lesions.
  
  
  RESULTS
  The initial clinical diagnosis was correct in 307, giving a positive predictive value of 89%. There were no significant difference between the groups with respect to age of patients (p = 0.59) and the size of the lesions (p = 0.42). According to our study, among misdiagnosed patients, nabothian cysts and cervicitis were the most common histological findings; FDPs were more often symptomatic (p < 0.001) and coexisted more frequently with inflammation or ulceration (p < 0.001). All FDPs were developing within the endocervical canal. There were no instances of FDPs that arise from ectocervix. Symptomatic polypoids have a higher risk of preliminary misdiagnosis (OR = 13.0; 95% confidence interval, 3.0-55.1).
  
  
  CONCLUSIONS
  All cervical polypoid lesions must be sent to pathology because visual diagnosis is not sufficiently accurate to direct patient care.
authors.affiliation: 1Department of Obstetrics and Gynecology, Selçuk University Medicine Faculty, Selçuklu; 2Konya Numune Hospital, Department of Family Medicine; and 3Department of Pathology, Selçuk University Medicine Faculty, Selçuklu, Konya, Turkey.
authors.forename: Mustafa Gazi
authors.initials: MG
authors.lastname: Uçar
authors.forename: Tolgay Tuyan
authors.initials: TT
authors.lastname: İlhan
authors.forename: Rahime Merve
authors.initials: RM
authors.lastname: Uçar
authors.forename: Pinar
authors.initials: P
authors.lastname: Karabağli
authors.forename: Çetin
authors.initials: Ç
authors.lastname: Çelik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003127:Colposcopy; D003951:Diagnostic Errors; D005260:Female; D006651:Histocytochemistry; D006801:Humans; D008875:Middle Aged; D011127:Polyps / Q000175:diagnosis*; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*