IS THERE A ROLE FOR CERVICOGRAPHY IN THE DETECTION OF PREMALIGNANT LESIONS OF THE CERVIX UTERI

The characteristics of cervicography and the Papanicolaou smear test h ave been compared for the detection of cervix lesions classified as CI N I or more. A total of 4,015 women were entered into the study. The s ensitivity of cervicography is significantly higher (McNemar test, P<0 .0001), but its specificity remains significantly lower (McNemar test, P<0.0001), and its higher sensitivity does not apply to lesions class ified as CIN II or more (high-grade lesions). Hence, if patients with a positive screen result are to be referred for colposcopy-biopsy, cer vicography is not a suitable alternative to the smear test for the scr eening of cervical cancer. However, cervicography can be envisaged as a complementary tool to the smear test because of(a) its higher capabi lity to detect high-grade lesions among women less than 35 years old a nd (b) its potential superiority in following low-grade lesions. It ma y also serve as a tool for quality assurance audit of the smear test.