Validity of colposcopy in the diagnosis of early cervical neoplasia--a review.

This study was conducted to quantify by meta-analysis the validity of colposcopy in the diagnosis of early cervical neoplasia in order to assess the justification of its integral role in this regard. Eight longitudinal studies were selected, which compared correlation of colposcopic impression with colposcopically directed biopsy results. The prevalence of disease in the studies ranged from 40 to 89%. Colposcopic accuracy was 89%, which agreed exactly with histology in 61% of cases. The sensitivity and specificity of colposcopy for the threshold normal versus all cervical abnormalities were 87-99% and 26-87% respectively. For the threshold normal and low grade SIL versus high grade SIL, the values were 30-90% and 67-97%. Likelihood ratios increased with disease severity. Colposcopy performed better in differentiation of high grade from low grade disease than in differentiation of low grade disease from normal cervix. Colposcopy is a valid tool for the diagnosis of early cervical neoplasia. Its integral role in the management of early cervical disease is justified.