Diagnostic Colposcopy for HPV/DNA Screen Positive Women at the Colposcopy Clinic Family Health Bureau, Colombo

Abstract

Background: HPV/DNA screening can be used as a primary cervical cancer screening method. The objective of the study was to describe colposcopy results of HPV/DNA screen positive women according to the Asia-Oceania guidelines of follow-up. Method: Descriptive longitudinal study was conducted from 1st of September 2018 to 28th of February 2020 from women, who were undergone for HPV/DNA screening under the pilot project carried out in public health divisions called Medical officer of Health (MOH) areas in Kalutara district. Study population comprised of 35 and 45 year age cohort ever married women in MOH areas of Kalutara district. HPV/DNA screen positive women with cytology results ≥ Atypical Squamous Cells of Undetermined Significance (≥ASCUS) were referred to colposcopy. Total number of 106 women were referred to FHB colposcopy clinic. Total number of 95 women were subjected to biopsy and biopsy screening was carried out by a machine by the Consultant Histopathologist. Results: Percentage of biopsy tissue abnormality among overall HPV/DNA screen positive women with cytology ≥ASCUS was 81.05% (77/95). Percentage of biopsy tissue abnormality among HPV/DNA genotypes 16 and 18 screen positive women with cytology ≥ASCUS was 92.7% (51/55). Percentage of women subjected to biopsy following abnormal colposcopy results was 89.6% (95/106). Among all biopsy screened 4.6% (5/95) were cervical cancer, 8% (8/95) were High Grade Squamous Intraepithelial Lesions (HGSIL) and 67.36% were Low Grade Squamous Intraepithelial Lesions (LGSIL) (64/95). Conclusions: Colposcopy and biopsy of HPV/DNA screen positive follow-up has revealed a very high detection rate of Cervical Intraepithelial Neoplasia (CIN). Therefore, HPV/DNA screening as a primary cervical cancer screening method should be considered as it is suitability was well assessed at Sri-Lankan setting.