Abstract
Objective. The aim of this study is to compare colposcopic findings and the accuracy of colposcopic impression in HIV seropositive and seronegative women with abnormal Pap tests. Methods. HIV seropositive and seronegative women in a national cohort study had Pap tests collected every six months, with colposcopy for any abnormal result. Prospectively collected colposcopy and histology findings were analyzed retrospectively using Pearson Chi-square, t-test and Wilcoxon two-sample tests, logistic regression models, and Kappa coefficients. Results. After adjusting for age and Pap result, 1618 eligible HIV seropositive women were more likely than 406 seronegative women to have inadequate colposcopic examinations, abnormal colposcopic findings, and large cervical lesions. However, among those with abnormal colposcopy, colposcopic characteristics and lesion size and number did not differ by HIV serostatus. Agreement between colposcopists' impressions and highest grade biopsy diagnoses was fair (kappa coefficient 0.35, 95% C.I. 0.31, 0.38). Agreement did not differ by HIV serostatus and did not improve with multiple biopsies (weighted kappa coefficient 0.35, 95% C.I. 0.32, 0.39) or after including all histology results over two years following colposcopy. Conclusion. Although HIV seropositive women with abnormal cytology are more likely to have colposcopic abnormality, the performance of colposcopy appears to be similar to that in HIV seronegative women. Biopsy is required to confirm colposcopic impression.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 481-486 |
| Number of pages | 6 |
| Journal | Gynecologic oncology |
| Volume | 135 |
| Issue number | 3 |
| DOIs | |
| State | Published - Dec 1 2014 |
Funding
Clinical data and specimens in this manuscript were collected by the Women's Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington DC Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange). The WIHS is funded by the National Institute of Allergy and Infectious Diseases ( UO1-AI-35004 , UO1-AI-31834 , UO1-AI-34994 , UO1-AI-34989 , UO1-AI-34993 , and UO1-AI-42590 ) and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development ( UO1-HD-32632 ). The study is co-funded by the National Cancer Institute , the National Institute on Drug Abuse , and the National Institute on Deafness and Other Communication Disorders . Funding is also provided by the National Center for Research Resources (UCSF-CTSI grant number UL1 RR024131 ). The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Keywords
- Cervical intraepithelial neoplasia
- Colposcopy
- HIV in women
- Pap test
ASJC Scopus subject areas
- Oncology
- Obstetrics and Gynecology
