Reliability of Colposcopy in Turkey: Correlation with Pap Smear and 1-year Follow Up

  • Mesci-Haftaci, Simender (Department of Obstetrics and Gynecology, Duzce Public Hospital) ;
  • Ankarali, Handan (Department of Biostatistics, School of Medicine, Duzce University) ;
  • Caglar, Mete (Department of Obstetrics and Gynecology, School of Medicine, Duzce University) ;
  • Yavuzcan, Ali (Department of Obstetrics and Gynecology, School of Medicine, Duzce University)
  • Published : 2014.09.15


Background: A cytologic reading of a Papanicolaou (pap) smear followed, if the result is positive, by a colposcopic search for abnormal cells is the most common screening method for cervical cancer used worldwide. We aimed to present the correlation of smear and colposcopic findings with 6- to 12-month follow-up results and related factors in women who underwent colposcopy in Turkey. Materials and Methods: The study population consisted of women who attended the gynecology department and were referred for colposcopic evaluation in 2011-2012. A total of 232 women between ages 17 and 68 years were included. Colposcopy indications were ASCUS and higher lesions at cervical smear, macroscopic suspicious lesions, post-coital bleeding history with suspicious smear, and repeated cervical inflammation. All patients were recalled for 6- to 12-month follow-ups. Results: The most common colposcopy indication was ASCUS, and the most common biopsy result was inflammation. Nearly half of the patients returned for the control 6-month follow-up, and almost 20% of patients for a 1-year follow up. Conclusions: Colposcopic biopsy is an effective method in indicated patients but is not sufficient in itself if awareness of the subject is not raised in the population. One of the most important aims of cancer screening programs should be enabling patients in developing countries to take responsibility. Patients must be encouraged to apply to the hospital for better disease control.


  1. Matsumoto K, Oki A, Furuta R, et al (2010). Tobacco smoking and regression of low-grade cervical abnormalities. Cancer Sci, 101, 2065-73.
  2. Nazeer S, Shafi MI (2011). Objective perspective in colposcopy. Best Pract Res Clin Obstet Gynecol, 25, 631-40.
  3. Ouitrakul S, Udomthavornsuk B, Chum Worathayi B, luanratanakorn S, Supoken A (2011). accuracy of colposcopically directed biopsy in diagnosis of cervical pathology at srinagarind hospital. Asian Pac J Cancer Prev, 12, 2451-3.
  4. Poomtavorn Y, Suwannaruk K, Thaweekul Y, Maireang K (2011). Risk factors for high-grade cervical intraepithelial neoplasia in patients with atypical squamous cells of undetermined significance(ASC-US) Papanicolaou Smears. Asian Pac J Cancer Prev, 12, 235-8.
  5. Porras C, Wentzen N, Rodriguez A, et al (2012). Switch from cytology-based to human papillomavirus test-based cervical screening: implications for colposcopy. Int J Cancer. 130, 1879-87.
  6. Pity IS, Shamdeen MY, Wais SA (2012). Follow up of atypical squamous cell Pap Smears in Iraqi women. Asian Pac J Cancer Prev, 13, 3455-60.
  7. Sankaranarayanan R, Gaffikin L, Jacob M, Sellors J, Robles S (2005). A critical assessment of screening methods for cervical neoplasia. Int J Gynecol Obstet, 89, 4-12.
  8. Sexually transmitted diseases treatment guidelines (2002). Centers for disease control and prevention. MMWR Recomm Rep, 10, 1-78.
  9. Tatiyachonwiphut M, Jaishuen A, Sangkarat S et al (2014). Agreement between colposcopic diagnosis and cervical pathology: Siriraj hospital experience. Asian Pac J Cancer Prev, 15, 423-6.
  10. Wentzensen N, Schiffman M, Dunn ST et al (2009). Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women referred to colposcopy in Oklahoma. Int J Cancer, 124, 964-9.
  11. Walker P, Dexeus S, De Palo G, et al (2003). International terminology of colposcopy: An updated report from the international federation for cervical pathology and colposcopy. Obstet Gynecol, 101, 175-7.
  12. Aksan-Desteli G, Gursu T, Baykal CM (2014). Is the loop electrosurgical excision procedure necessary for minor cervical cytological abnormalities? Asian Pac J Cancer Prev, 15, 305-8.
  13. Ayensu-Coker L, Sanchez J, Zurawin R, Dietrich JE (2009). Use of misoprostol for management of unsatisfactory colposcopy in the adolescent : a case report of review of the literature. J Pediatr Adolesc Gynecol, 22, 139-41.
  14. Baldauf JJ, Dreyfus M, Wertz JP, et al (1997). Consequences and treatment of cervical stenoses after laser conization or loop electrosurgical excision. J Gynecol Obstet Biol Reprod (Paris), 26, 64-70.
  15. Bhutia K, Puri M, Gami N, Aggarwal K, Trivedi SS (2011). Persistent inflammation on Pap smear: does it warrant evaluation? Indian J Cancer, 48, 220-2.
  16. Cheng X, Feng Y, Wang X, et al (2013). The effectiveness of conization treatment for post-menopausal women with high-grade cervical intraepithelial neoplasia. Exp Ther Med, 5, 185-8.
  17. Dasari P, Rajathi S, Kumar SV (2010). Colposcopic evaluation of persistent inflammatory Pap smear: A prospective analytical study. Cytojournal, 5, 7-16.
  18. Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917.
  19. Kelly RS, Walker P, Kitchener H, Moss SM (2012). Incidence of cervical intraepithelial neoplasia grade 2 or worse in colposcopy-negative/human papillomavirus-positive women with low-grade cytological abnormalities. BJOG, 119, 20-5.
  20. Matsumoto K, Hirai Y, Furuta R, et al (2012). Subsequent risk for cervical precancer and cancer in women with lowgrade squamous intraepithelial lesions unconfirmed by colposcopy-directed biopsy: results from a multicenter, prospective, cohort study. Int J Clin Oncol, 17, 233-9.