[Colpo-hystopathological correlation as quality index in colposcopy]

Colposcoy is a method of evaluation in women with abnormal cytologies that must be handled with a control system of quality and performed within the acceptable standards.

To evaluate, through colpo-histopathologic correlation, some quality indicators of colposcopic studies (both diagnostic and operatory) in colposcopic clinic at Hospital General de México.

Longitudinal, retrospective, and descriptive study that analyses 3,142 surgical specimens registered as cervical conizations. Data were presented as percentages and in 2 by 2 tables.

349 conizations (11.11%) were performed in women with less than 25 years-old, and 10 in women with less than 17 years-old, without a justifiable indication. Colposcopic studies found 2598 (82.68%) abnormal cases (LGSIL, HGSIL, epidermoid cancer or adenocarcinoma). Among these cases, only 1163 had a histopathologic verification (colpo-histopathologic correlation of 44.77%, quality control standard > 80%). Difference represents 1435 false positive colposcopic findings. Among the 544 (17.32%) colposcopic normal cases, in which conization was unjustifiable, histopathologic studies showed that 457 (84%) had some histopathologic abnormality (> or = LGSIL), most of them false negative cases. Colposcopic differentiation between normal vs. abnormal findings shows: sensibility 71.79% (low); specificity 5.72% (extremely low); positive predictive value 44.75% (very low); and predictive negative value 15.99% (extremely low). In 75.5% of surgical margins of conizations with diagnosis of > HGSIL there was a disease.

Colposcopic practice of this medical group is very poor, and due to this there are a lot of unnecessary conizations performed that represents an unjustifiable waste of human and material resources.

Federal health authorities should regulate colposcopy performance and teaching to guarantee the quality that patients deserve.