OBJECTIVE: The present audit was carried out to assess the diagnostic accuracy of cervical punch biopsy during colposcopy in comparison with diagnosis from subsequent cone excision.DESIGN AND SETTING: Retrospective analysis was performed by examining the histopathology reports for paired cervical punch biopsies and cervical cone excisions for cases reported from April 2004 to March 2005 (when cervical biopsies and cones were reported by general pathologists) and from January to December 2008 (when reporting by specialist gynaecological pathologists was instituted).SAMPLE: 150 women had both cervical punch and cone biopsies performed in the 2004-2005 period, while 149 women had both biopsies performed in 2008.MAIN OUTCOME MEASURES AND RESULTS: In 2004-5, the rate of consistent diagnosis was 68.7%, compared with 75.8% in 2008. This was due to a decrease in the rates of overdiagnosis (16.7% vs. 14.8%) and underdiagnosis (14.7% vs. 9.4%), which was statistically significant. The sensitivity rates for 2004-5 and 2008 were 87.5% and 89.7%, and the specificity rates for the same periods were 39.8% and 39.4% respectively.CONCLUSIONS: This audit highlights the importance of planning patient management on the basis of co-ordinated information from smear results, history, colposcopy findings and cervical biopsies. The introduction of specialist gynaecological histopathology reporting has significantly improved the rates of consistent diagnosis.
Adult Aged