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Assessing colposcopy competencies in medically underserved communities: a multi-center study in China
Xiaoli Cui1,2, Huike Wang3, Mingyang Chen3
1Dalian Medical University, Dalian, Liaoning, 116044, China.
BMC Cancer
|March 20, 2024
Summary
Colposcopists in underserved Chinese communities show low accuracy in diagnosing cervical lesions and deciding on biopsies. Increased experience improves performance, highlighting the need for better training in colposcopy.
Area of Science:
- Gynecology
- Oncology
- Public Health
Background:
- Colposcopy is crucial for diagnosing cervical lesions and guiding biopsies.
- Limited research exists on colposcopist competency in China's underserved regions.
Purpose of the Study:
- To assess the competency of colposcopists in medically underserved areas of China.
- To identify factors influencing colposcopic performance.
Main Methods:
- 214 colposcopists from underserved Chinese communities participated.
- Assessments included image-based case studies evaluating transformation zone (TZ) type, diagnosis, and biopsy decisions.
- Participants were categorized by annual case volume (50 examinations).
Main Results:
- Accuracy was low for TZ determination (0.47) and colposcopic diagnosis (0.53).
- Biopsy decision accuracy was 0.73; sensitivity for high-grade lesions was 0.61, and specificity was 0.80.
- Colposcopists performing >50 cases annually demonstrated higher accuracy and sensitivity.
Conclusions:
- Colposcopists in underserved Chinese communities exhibit suboptimal performance in TZ identification, diagnosis, and biopsy decisions.
- Higher annual case volume correlates with improved colposcopic skills.
- There is a critical need for enhanced pre-professional and clinical training to improve colposcopy practice.
