Summary:
Cervical cancer is the commonest form of cancer in women
in virtually all developing countries1. It is the third most
common cancer among women worldwide2. Almost 80% of
cervical cancer occurs in developing countries. In
developed nations, the figure for invasive cervical cancer
are much lower due to adaptation of different screening
tests1. All sexually active women are at risk of acquiring a
Human Papilloma Virus (HPV) infection which may lead
to cervical cancer in the future3. Cervical cancer is a
preventable disease as the different screening, diagnostic
and therapeutic procedures are effective. The screening
procedures are VIA (Visual inspection of cervix with acetic
acid), Pap’s smear and HPV DNA test. Colposcopy is the
triage in screening, taking colpospoy directed biopsy as
well as treatment of CIN such as cold coagulation,
cryotherapy, and LEEP (Loop electro-surgical excision
procedure)4.
Objective: To study the role of Colposcopy in the evaluation
VIA positive cases of unhealthy cervix, to localize the leisons
to obtain the biopsies from the selected areas and detection
of precancerous lesion of cervix for early management.
Meterials and Methods: This was a prospective
observational study done among 306 married women aged
18-65 years who had clinically unhealthy cervix attending
the VIA and colposcopy clinic in Department of Obstetrics
and Gynaecology of Sir Salimullah Medical College and
Journal of Bangladesh College of Physicians and Surgeons
Vol. 37, No. 2, April 2019
Mitford Hospital from January 2015 to December 2016.
All the patients were subjected to VIA test. Colposcopic
evaluation done in VIA positive cases and the findings
were noted. Colposcopy directed biopsy was taken from
colposcopically suspected areas.
Results: Out of 306 cases, 63 women had positive VIA tests
and 233 women had negative VIA tests. Colposcopic
evaluation were undertaken among 63 VIA positive cases.
Colposcopy directed punch biopsy revealed that 28
(60.32%) cases had positive lesions like CIN or invasive
carcinoma and 25 (39.68%) had neither CIN or invasive
lesions . Among positive leisons about 30.16% had CINI,
1.59 % had CIN II, 0% had CIN III and 28.57% had
invasive carcinoma. In this study sensitivity and specificity
of colposcopy examination of VIA positive cases were found
94.74% and 56% respectively.
Conclusion: It is evident that colposcopy plays a very
important role in the evaluation of VIA positive cases of
unhealthy cervix. So that early diagnosis and treatment of
preinvasive and early invasive carcinoma of cervixis is
possible. So wide use of colposcopy in screening program
of Bangladesh speciallly in the VIA positive cases can
reduce the many young women’s morbidity and mortality.
(J Bangladesh Coll Phys Surg 2019; 37: 60-65)
DOI: https://doi.org/10.3329/jbcps.v37i2.40561