BACKGROUND: Cervicography is an adjunct method of cervical cancer screening intended to complement cervical cytologic sampling, ie, Papanicolaou (Pap) smear. Cervicography involves obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the screening use of cervicography as an adjunct to clinical cytologic screening. METHODS: Women presenting at four clinical sites for annual cervical cytologic screening or for follow-up evaluation after receiving an abnormal Pap smear result were enrolled in the study. Each patient received a Pap smear and a cervigram. Those women in whom abnormalities were detected by either test subsequently underwent colposcopy, and when appropriate, histologic specimens were obtained. RESULTS: Pap smear and cervigram data were obtained for 1449 women. When premalignant or malignant histologic test results were considered as a true positive, the Pap smear correctly identified 25.6% of subjects with dysplasia and 37.5% with severe dysplasia. The Pap smear failed to identify the one patient with invasive cancer. The cervigram detected 50.5% of the subjects with dysplasia and 77.8% of the subjects with severe dysplasia, and it identified the one patient with invasive cancer when a positive cervigram was considered a true positive. When the results were combined, the two tests identified 62.9% of subjects with histologically confirmed dysplasia, 81.3% of subjects with severe dysplasia, and 100% (one patient) with cancer. CONCLUSIONS: The cervigram detected twice the number of patients with premalignant disease as the Pap smear alone, and correctly identified the invasive cancer. Cervicography improved the detection of cervical disease.
BACKGROUND: Cervicography is an adjunct method of cervical cancer screening intended to complement cervical cytologic sampling, ie, Papanicolaou (Pap) smear. Cervicography involves obtaining and evaluating a photographic image of the cervix. The purpose of this investigation was to evaluate the screening use of cervicography as an adjunct to clinical cytologic screening. METHODS:Women presenting at four clinical sites for annual cervical cytologic screening or for follow-up evaluation after receiving an abnormal Pap smear result were enrolled in the study. Each patient received a Pap smear and a cervigram. Those women in whom abnormalities were detected by either test subsequently underwent colposcopy, and when appropriate, histologic specimens were obtained. RESULTS: Pap smear and cervigram data were obtained for 1449 women. When premalignant or malignant histologic test results were considered as a true positive, the Pap smear correctly identified 25.6% of subjects with dysplasia and 37.5% with severe dysplasia. The Pap smear failed to identify the one patient with invasive cancer. The cervigram detected 50.5% of the subjects with dysplasia and 77.8% of the subjects with severe dysplasia, and it identified the one patient with invasive cancer when a positive cervigram was considered a true positive. When the results were combined, the two tests identified 62.9% of subjects with histologically confirmed dysplasia, 81.3% of subjects with severe dysplasia, and 100% (one patient) with cancer. CONCLUSIONS: The cervigram detected twice the number of patients with premalignant disease as the Pap smear alone, and correctly identified the invasive cancer. Cervicography improved the detection of cervical disease.