Diagnostic Concordance between Cytology, Colposcopy and Biopsy in Cervical Cancer in Chihuahua, Mexico

Background: Cervical cancer is the second leading cause of death in women worldwide and the first in developing countries. In Mexico, it is the leading cause of cancer death in women over 35 years of age. Cytology, colposcopy and biopsy are complementary systems for the study of patients with cervical pathology and are diagnostic methods that must be evaluated continuously. Early identification through screening is key to prognosis and treatment since it is curable in primary stages. Aim: So the purpose of this study is to know the diagnostic concordance between cytology, colposcopy and biopsy in patients with cervical cancer in Chihuahua, Mexico. Design and Setting: Comparative cross-sectional study. Methods: A total of 74 records were reviewed and women with cervical cancer diagnosed with cytology, colposcopy and biopsy were identified at the Gynecology and obstetrics hospital #15 in the year 2014. The Kappa coefficient was used for concordance between diagnostic tests, sensitivity and positive predictive value of cytology and colposcopy were calculated compared to biopsy (gold standard). Results: poor concordance was found between cytology-biopsy findings (K=0.08) and between colposcopy-biopsy (K=0.06), however, moderate concordance was found between citology-colposcopy (K=0.504, p=0.001). Conclusion: Cytology and colposcopy as diagnostic methods for cervical cancer have low sensitivity and high positive predictive values, their level of concordance compared to the gold standard is also low according to the Kappa coefficient; however, the degree of concordance between cytology and colposcopy is moderate with a significant Kappa coefficient.