1454P - Evaluation of colposcopy and loop electrosurgical excision procedure (LEEP) in a rural mobile cervical cancer screening unit in west Bengal, India

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Cervical Cancer
Cancer Aetiology, Epidemiology, Prevention
Presenter Sukanta Koner
Authors S. Koner1, C.K. Bose2, A.N. Sen3, A. Mukhopadhyay4
  • 1Community Medicine, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 2Dept. Of Gynocological Oncology, Netaji Subhash Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN
  • 3Surgical Oncology, NETAJI SUBHASH CHANDRA BOSE CANCER RESEARCH INSTITUTE, 700016 - KOLKATA/IN
  • 4Dept. Medical Oncology, Netaji Subhas Chandra Bose Cancer Research Institute, 700016 - Kolkata/IN

Abstract

Background

In recent years there are many attempts to see accuracy of colposcopy in poor resource setting where ‘see and treat’ approach is used. Sensitivity and specificity for colposcopy in India is not determined accurately so far because of poormethodology of experiments.

Objectives

Hence, in a cervical cancer screening and management project for rural poor women in West Bengal province of India we tried to calculate specificity and sensitivity of colposcopy based on management by LEEP.

Methods

VIA combined with colposcopy and LEEP using mobile van is planned in a biotechnology based programme for women under Department of Biotechnology, Govt. of India where efficacy of colposcopy was assessed by camp approach in rural area of a remote district. We used video colposcopy as triage and managed positive cases by LEEP. We randomly selected 50 cases that wereColposcopy negative & 50 cases with CIN I and did biopsy cervix on all of them. We thus evaluated our early screeningand management to detect sensitivity & specificity of Colposcopy in this rural setting.

Results

A total of 2836 women participated in our rural camp for screening during this period. We could detect 415 VIA positive cases. In this gold standard test we saw 12 cases of false positive. Only 14 cases of false negative that then underwent LEEP. Thus colposcopy in our series had 60% sensitivity and 63% positive predictive value while 87.7% specificity and 86% negative predictive value. Complication Rate was 3 percent (14 cases).

Conclusion

In our series sensitivity of colposcopy was comparatively low. Main confounding variable producing false positive result was inflammation of cervix which seems to be a cause of concern in our country. However, obustness of VIA needs to be calculated in a bigger study to find out efficacy of such screening.

Disclosure

All authors have declared no conflicts of interest.