Digital Colposcopy Enhances Cervical Cancer Detection
(HealthDay News) – Dynamic spectral imaging (DSI) colposcopy is more sensitive for detecting cervical intraepithelial neoplasia (CIN2+) in women who are human papillomavirus type 16-positive (HPV16+) than for women who are non-16 high-risk (hr) HPV+, according to a study published online Feb. 3 in BJOG: An International Journal of Obstetrics and Gynaecology.
Afra Zaal, MD, of the University Medical Center Utrecht in the Netherlands, and associates conducted a prospective clinical trial involving 177 adult women (age 18 years or older) with an intact cervix, referred for colposcopy at three clinics, to investigate the agreement between conventional colposcopic impression, DSI colposcopy, and histology. Lesions were graded using the DSI colposcope as a regular video colposcope. HPV typing was performed with a cervical smear.
The researchers found that DSI digital colposcopy identified more CIN2+ lesions in HPV16+ women than in non-16 hrHPV+ women (P=0.032 regardless of final histology and P=0.009 among women with CIN2+). Data showed that the sensitivity of DSI colposcopy to detect CIN2+ lesions was 97% in HPV16+ women, compared with 74% in non-16 hrHPV+ women (P=0.009). These differences were not seen for the colposcopist impression. The colposcopist mainly missed smaller cervical lesions.
"The sensitivity of DSI colposcopy for CIN2+ is higher in HPV16+ than in non-16 hrHPV+ women," the authors write. "Furthermore, regardless of HPV16 status, the sensitivity of DSI for CIN2+ is higher than that of the colposcopist, probably because colposcopists tend to miss smaller cervical lesions."
Several authors disclosed financial ties to DySIS Medical Ltd., which partially funded the study and provided the DSI digital colposcope used in the study.