Colposcopic Findings and Their Correlation with Histopathological Diagnosis in VIA-Positive Cervical Lesions: A Hospital-Based Study

Open Access

Abstract

Background: Colposcopy is used to guide biopsy and treatment decisions in women who have a positive visual inspection with acetic acid (VIA) test, but the relationship between colposcopy and histopathology should be assessed locally. The purpose of this study was to describe the colposcopy findings and to correlate them with the histopathology diagnosis in VIA-positive women. Methods & Materials: This was a cross-sectional study conducted in the hospital setting with 120 women who were VIA-positive from January 2024 to December 2024 at the Department of Obstetrics and Gynaecology, Barishal General Hospital, Barishal, Bangladesh. Sociodemographic, reproductive, and clinical data were obtained; colposcopy was carried out, and directed biopsies were obtained. Histopathology was used as a reference method. The diagnostic performance for CIN II or worse and Cohen's kappa were computed. Results: Women aged 31-50 years made up 67.5%, 60.8% were rural, 64.2% had parity of three or more, 63.3% were married before 18 years, and 80.8% had no previous screening. Major changes were seen in 40.8% and suspicious for invasion in 6.7% on colposcopy. Histopathology revealed benign lesions in 20.8%, CIN I in 32.5%, CIN II in 20.8%, CIN III in 19.2%, and invasive squamous cell carcinoma in 6.7%. Major changes were associated with CIN II-III (81.6%), and all suspicious impressions were carcinoma. Sensitivity was 85.7%, specificity 85.9%, positive predictive value 84.2%, negative predictive value 87.3%, accuracy 85.8%, and kappa 0.715 for CIN II or worse. Conclusions: There was an agreement between colposcopy and histopathology and good diagnostic value of colposcopy for high-grade lesions in women with VIA-positive results, but directed biopsy is still necessary for confirmation.