Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

Aim: To evaluate the agreement between colposcopic diagnosis and cervical pathology a retrospective chartreview was performed. Materials and
Methods: This study included 437 patients who underwent colposcopyand cervical biopsy or conization at Siriraj Hospital from October 2010 - December 2012. The patient clinicalcharacteristics, cervical cytology results, colposcopic diagnoses, cervical pathology results were recorded andcorrelations between variables were analyzed.
Results: Agreement of colposcopic diagnosis and cervical pathologywas matched in 253 patients (57.9%). The strength of agreement with weighted Kappa statistic was 0.494 (p<0.001).Colposcopic diagnoses more often overestimated (31.1%) than underestimated (11%) the cervical pathology.Agreement of colposcopic diagnosis and cervical pathology within 1 grade was found in 411 patients (94.1%).Positive predictive value (PPV) of high grade colposcopy or more was 75.5%, whereas the negative predictivevalue (NPV) of insignificant and low grade colposcopy was 83.8%. False positives of high grade colposcopy ormore were 21%. False negatives of insignificant or low grade colposcopy were 19.1%.
Conclusions: Strength ofagreement between colposcopic diagnosis and cervical pathology was found to be only moderate. A biopsy atcolposcopy should be performed at a gold standard level to detect high grade lesions.