VALIDITY OF COLPOSCOPY TO IDENTIFY AND GRADE SQUAMOUS INTRAEPITHELIALLESIONS AMONG VENEZUELAN WOMEN

To assess the validity of colposcopy to correctly detect and grade squ amous intraepithelial lesions (SIL) in Venezuelan women, we did a pros pective, nonrandomized and cross sectional study on patients referred with low-grade and high-grade SIL. After a second cervical smear, they were colposcopically evaluated and biopsied. The outcome measures wer e interobserver variation, sensitivity, specificity, and predictive va lues. Ninety-nine patients were evaluable. Colposcopy had poor agreeme nt with repeat cervical smears, and moderate to good agreement with co nization biopsy (kappa = 0.55; 95% C.I.: 0.45 to 0.65), with a sensiti vity of 0.87, a specificity of 0.69, a positive predictive value of 0. 85 and a negative predictive value of 0.71 for high-grade SIL. The cri terion of colposcopic vascular atypias was accurate enough to detect a nd grade SIL, showing good agreement with histopathology. Because of t he disparity of results in previous reports, only a carefully designed , randomized study will settle this question.