Telecolposcopy - a feasibility study in primary care

Organized cervical screening has reduced the incidence of invasive cervical cancer, but this has resulted in large numbers of women requiring investigation. We have investigated the negative predictive value of colposcopy and used telemedicine to develop a secondary screening technique for use in primary care. A video-colposcope was used to record video-clips, which were subsequently transmitted to a specialist for interpretation. The gold standard for the comparison was the opinion of the colposcopist who examined the women in the hospital colposcopy clinic. Eighty-one out of 97 women were studied by both techniques. Using a diagnosis of normal or abnormal, telecolposcopy had a sensitivity of 88.9% and a specificity of 93.3%. There was very good agreement between the telecolposcopy screener and the colposcopist (Cohen s kappa statistic = 0.70). Furthermore, telecolposcopy screening did not grade any cases of colposcopic high-grade cervical intraepithelial neoplasia as normal. The pilot study has established the validity of diagnosing from transmitted computerized video-clips.