Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

  • Tatiyachonwiphut, Molpen ;
  • Jaishuen, Atthapon ;
  • Sangkarat, Suthi ;
  • Laiwejpithaya, Somsak ;
  • Wongtiraporn, Weerasak ;
  • Inthasorn, Perapong ;
  • Viriyapak, Boonlert ;
  • Warnnissorn, Malee
  • Published : 2014.01.15


Aim: To evaluate the agreement between colposcopic diagnosis and cervical pathology a retrospective chart review was performed. Materials and Methods: This study included 437 patients who underwent colposcopy and cervical biopsy or conization at Siriraj Hospital from October 2010 - December 2012. The patient clinical characteristics, cervical cytology results, colposcopic diagnoses, cervical pathology results were recorded and correlations between variables were analyzed. Results: Agreement of colposcopic diagnosis and cervical pathology was 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 predictive value (NPV) of insignificant and low grade colposcopy was 83.8%. False positives of high grade colposcopy or more were 21%. False negatives of insignificant or low grade colposcopy were 19.1%. Conclusions: Strength of agreement between colposcopic diagnosis and cervical pathology was found to be only moderate. A biopsy at colposcopy should be performed at a gold standard level to detect high grade lesions.


Colposcopic diagnosis;cervical pathology;agreement;biopsy


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Supported by : Mahidol University