Colposcopic Evaluation of Clinically Unhealthy Cervix and Its Correlation with Histopathological Findings

Open Access

Abstract

Background: A clinically unhealthy cervix, with features such as erosion, discharge, and bleeding, is often a symptom of underlying pre-malignant or malignant pathology, and therefore needs to be promptly evaluated. This study aimed to assess colposcopic findings in clinically unhealthy cervix cases and correlate them with histopathological diagnoses to ascertain the diagnostic accuracy of colposcopy. Methods & Materials: This is a cross-sectional study carried out at the Department of Gynaecology and Obstetrics, BIRDEM Women and Children Hospital, Dhaka, Bangladesh, from January to December 2024, with 146 women with an unhealthy cervix clinically. The diagnostic tests used were VIA, Pap smear, colposcopy, and colposcopy-directed biopsy, with histopathology being the gold standard method. Statistical analysis was performed using SPSS version 26, and Spearman's coefficient was used to determine the correlation between colposcopy and histopathology results. Results: Most of the patients were aged between 30 and 49 years (49.9%) and were living in rural areas (55.5%). The most common presenting symptom was a white vaginal discharge (31.5%). VIA was positive in 47.9% of cases. The positive rate of colposcopy was 71.2%. Histopathological findings showed CIN 1, 20.5%; CIN 2, 22.6%; CIN 3, 17.8%; carcinoma, 21.9%, and chronic cervicitis, 17.1%. The Spearman correlation between colposcopic and histopathological findings was 0.14 (p = 0.309). Conclusion: Colposcopy showed a high positivity rate in clinically unhealthy cervix with weak correlation with histopathological findings, thus highlighting the indispensable role of colposcopy-directed biopsy for definitive diagnosis. Integration of VIA, Pap smear, and colposcopy in the multimodal approach increases cervical cancer screening effectiveness, especially in resource-limited settings.