Objective: To evaluate the probability of the detection of high-grade dysplasia (cervical intraepithelial neoplasia (CIN) 2,3 or vaginal intraepithelial neoplasia (VAIN) 2,3) or locally recurrent cancer in treated women for cervical cancer with abnormal conventional Pap smear
Method: A screening test research, retrospective descriptive diagnostic test study, by reviewing medical records of 115 cervical cancer patients with abnormal conventional Pap smear through 149 colposcopic examinations at Maharat Nakhonratchasima hospital from October 1, 2012 to September 30, 2019.
Results: Fifty-four (36.2%) of colposcopic examinations revealed high-grade dysplasia or locally recurrent cancer. Twenty-eight (18.8%) were locally recurrent cancer. High grade smear patients had a higher risk to detect high-grade dysplasia or locally recurrent cancer than Low grade smear patients (Risk ratio: 3.19). The results led to 49.5% (95% CI 38.8-60.1) and 15.5% (95% CI 7.3-27.4) of positive predictive value (PPV) in High grade smear and Low grade smear, respectively. 2 of 3 locally recurrent cancer-detected patients in Low grade smear also had a Human immunodeficiency virus (HIV) infection, with 5.2% (95% CI 1.1-14.4) of PPV in locally recurrent cancer detection.
Conclusion: Cervical cancer patients with High grade smear on conventional Pap smear should undergo immediate colposcopic examination, while HIV-uninfected patients with Low grade smear (ASC-US, LSIL) can be followed without colposcopy.