Correlation of colposcopy and histology in cervical biopsies positive for CIN and/or HPV infection

The purpose of our study was the investigation of colposcopic findings in 108 patients with histologically proved CIN and/or HPV infection in colposcopically directed cervical punch biopsies. The chi square test with Yates' correction was used for the statistical analysis. In 82 cases there were histological changes suggestive of HPV infection, 91 cases showed CIN while in 65 cases CIN was superimposed on HPV infection. The sensitivity of colposcopy was 89% for the detection of CIN and 61% for HPV. In 45% of CIN cases colposcopy underdiagnosed the CIN level, especially in more severe lesions (level II or higher, P < 0.001). We have also observed that the HPV-related colposcopic findings significantly increased the probability of underdiagnosing CIN (P < 0.05). Our results suggest that biopsy is always necessary in order to establish the diagnosis and determine the severity of CIN, especially if the colposcopist suspects HPV infection. We have also shown that many cases of HPV infection are not detected by colposcopy, because they are masked by the coexisting CIN.