A COMPARISON OF CYTOLOGY AND CERVICOGRAPHY IN CERVICAL SCREENING

The sensitivity and specificity of cervical cytology and of cervicogra phy in the detection of CIN and invasive cancer of the cervix were det ermined in a screening programme of an asymptomatic population of 418 women. Because all of the subjects were examined colposcopically and b iopsies were taken from any suspicious areas, the presence or absence of disease was determined by the histology of directed cervical biopsi es independently of the screening methods being tested. Cervicography correctly identified 24 of the 27 women with CIN or invasive cancer, w hereas cytology detected only 14 (sensitivity of 0.89 vs. 0.52; P<0.01 ). Cervicography detected CIN in 11 women with negative smears, six ha ving CIN III. Only one case of CIN I was detected by cytology when cer vicography was negative. Two cases of CIN II were not detected by eith er method. Inclusion in the analysis of the results from 23 women with technically defective cervigrams reduced the size of the difference i n sensitivity, but it remained significant (0.74 vs. 0.48; P<0.05). Ce rvicography was only slightly less specific than cytology (0.92 vs. 0. 94; NS). Cervicography appears to be more effective than cytology in s creening for cervical premalignancy but may be more demanding of those who perform the test.