Cervicography screening for cervical cancer among 8460 women in a high-risk population

OBJECTIVE: Cervicography was evaluated as a primary screening method for ce rvical cancer. STUDY DESIGN: Cervigrams of 8460 women were taken on enrollment into a popu lation-based study of cervical neoplasia. Cervicography results were compar ed with a referent diagnosis determined by histologic analysis and 3 cytolo gic tests, and with the performance of conventional cytologic evaluation. RESULTS: Cervicography identified all 11 cancers, whereas cytologic testing missed 1. Cervicography yielded sensitivities for detecting high-grade squ amous intraepithelial lesions or cancer of 49.3% overall (specificity, 95.0 %), 54.6% in women younger than 50 years of age, and 26.9% in women 50 year s of age and older. Cytologic testing yielded sensitivities for detecting h igh-grade squamous intraepithelial lesions or cancer of 77.2% overall (spec ificity, 94.2%), 75.5% in women younger than 50 years of age, and 84.6% in women 50 years of age and older. CONCLUSIONS: Cytologic testing performed better than cervicography for the detection of high-grade squamous intraepithelial lesions. Cervicography per formed marginally better than cytologic testing for the detection of invasi ve cervical cancer. Cervicography is not recommended for postmenopausal wom en.