Background: The cervicovaginal cytology or Papanicolaou (Pap) test allows the early diagnosis of cervical cancer. Success of cervical cancer screening depends, among other factors, on the diagnostic accuracy of Pap test. Objectives: To evaluate the diagnostic accuracy of cervicovaginal cytology in the detection of cervical lesions through cito-histopathological correlation. Methods: We evaluated the degree of correlation between the cytological results and cervical biopsies from 373 patients assisted at a university hospital in the period from 1990 through 1997. The indicators: sensitivity, specificity, positive and negative predictive values and false positive and false negative rates for cervicovaginal cytology diagnosis were calculated. Results: The crude rate of cito-histopathological correlation was 65.1%. The sensitivity of the Pap test was high (96%); its specificity, however, was low (51.5%), resulting in the inclusion of many false positive results. The rate of false positive results was 48.4%, whereas the rate of false negative results was 4%. Discussion: Despite the higher sensitivity of the test, its specificity is low, meaning that a lot of women would be falsely diagnosed as ill, resulting in a high number of false positive results and unnecessary costs, in addition to the potential iatrogenic character of this preventive practice. However, a highly sensitive test is the test of choice for the screening of cervical cancer among the female population. Conclusions: In order to guarantee the diagnostic accuracy of the Pap test, it is imperative to establish quality control activities for colpocytological and histopathological procedures, thus allowing success in early detection and treatment of cervical lesions.
Cervical cancer; Papanicolaou test; Validity; Diagnosis; Sensitivity; Specificity
