Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias

Background: Global strategies to eliminate cervical cancer will probably be followed by a drop in prevalence of precursor cervical neoplasias, leading to the need of improving colposcopic diagnostic performance that may negatively be affected. The aim of this study was to assess agreement among five...

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Main Authors: Giselle Fachetti-Machado, Rosane Ribeiro Figueiredo-Alves, Marise Amaral Rebouças Moreira, Rita Maira Zanine, Maria José de Camargo, Eliana Pereira dos Reis
Format: Article
Language:English
Published: IMR Press 2023-09-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009200
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author Giselle Fachetti-Machado
Rosane Ribeiro Figueiredo-Alves
Marise Amaral Rebouças Moreira
Rita Maira Zanine
Maria José de Camargo
Eliana Pereira dos Reis
author_facet Giselle Fachetti-Machado
Rosane Ribeiro Figueiredo-Alves
Marise Amaral Rebouças Moreira
Rita Maira Zanine
Maria José de Camargo
Eliana Pereira dos Reis
author_sort Giselle Fachetti-Machado
collection DOAJ
description Background: Global strategies to eliminate cervical cancer will probably be followed by a drop in prevalence of precursor cervical neoplasias, leading to the need of improving colposcopic diagnostic performance that may negatively be affected. The aim of this study was to assess agreement among five colposcopists regarding the presence of three isolated colposcopic images, and different degrees of colposcopic findings. Methods: In this retrospective study, two original colposcopists examined colposcopic images of patients treated between 2005 and 2018, classified them following the International Federation for Cervical Pathology and Colposcopy terminology, and evaluated them for the presence of obstructed dilated grouped glands, aceto-white villi with invaginated borders fused or not, and atypical vessels in cylindrical epithelium area. Posteriorly, three independent colposcopists also classified those colposcopic findings. The degree of agreement between the findings of the three independent, and the two original colposcopists was assessed using the Kappa (κ) coefficient. Results: Among the 822 included patients, 67.4% had a diagnosis of cervical intraepithelial neoplasia (CIN) grades 2 or 3, 6.8% of adenocarcinoma in situ, and 11.8% of CIN 1. The agreement for each image ranged from κ 0.14 to 0.37 (p < 0.001). The highest agreements occurred for aceto-white villi with invaginated borders (κ 0.15–0.37), major (κ 0.29–0.46), and minor (κ 0.14–0.36) colposcopic findings (p ≤ 0.001). Conclusions: The agreement among the three independent, and the two original colposcopists was statistically significant, ranging from weak to regular for the identification of three isolated colposcopic images, and from weak to moderate for the identification of major and minor colposcopic findings.
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spelling doaj-art-19615d9825ce40bd89fcef97d899680d2025-08-20T03:17:35ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632023-09-0150920010.31083/j.ceog5009200S0390-6663(23)02164-4Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor NeoplasiasGiselle Fachetti-Machado0Rosane Ribeiro Figueiredo-Alves1Marise Amaral Rebouças Moreira2Rita Maira Zanine3Maria José de Camargo4Eliana Pereira dos Reis5Post-graduate Program in Health Sciences, School of Medicine, Universidade Federal de Goiás, 74605-050 Goiânia, GO, BrazilPost-graduate Program in Health Sciences, School of Medicine, Universidade Federal de Goiás, 74605-050 Goiânia, GO, BrazilPost-graduate Program in Health Sciences, School of Medicine, Universidade Federal de Goiás, 74605-050 Goiânia, GO, BrazilDepartment of Gynecology and Obstetrics, School of Medicine, Universidade Federal do Paraná, 80060-240 Curitiba, PR, BrazilDepartament of Gynecology, Colposcopy Service, Fundação Oswaldo Cruz, 21040-900 Rio de Janeiro, RJ, BrazilColposcopy Service, Hospital Materno-Infantil, 74520-110 Goiânia, GO, BrazilBackground: Global strategies to eliminate cervical cancer will probably be followed by a drop in prevalence of precursor cervical neoplasias, leading to the need of improving colposcopic diagnostic performance that may negatively be affected. The aim of this study was to assess agreement among five colposcopists regarding the presence of three isolated colposcopic images, and different degrees of colposcopic findings. Methods: In this retrospective study, two original colposcopists examined colposcopic images of patients treated between 2005 and 2018, classified them following the International Federation for Cervical Pathology and Colposcopy terminology, and evaluated them for the presence of obstructed dilated grouped glands, aceto-white villi with invaginated borders fused or not, and atypical vessels in cylindrical epithelium area. Posteriorly, three independent colposcopists also classified those colposcopic findings. The degree of agreement between the findings of the three independent, and the two original colposcopists was assessed using the Kappa (κ) coefficient. Results: Among the 822 included patients, 67.4% had a diagnosis of cervical intraepithelial neoplasia (CIN) grades 2 or 3, 6.8% of adenocarcinoma in situ, and 11.8% of CIN 1. The agreement for each image ranged from κ 0.14 to 0.37 (p < 0.001). The highest agreements occurred for aceto-white villi with invaginated borders (κ 0.15–0.37), major (κ 0.29–0.46), and minor (κ 0.14–0.36) colposcopic findings (p ≤ 0.001). Conclusions: The agreement among the three independent, and the two original colposcopists was statistically significant, ranging from weak to regular for the identification of three isolated colposcopic images, and from weak to moderate for the identification of major and minor colposcopic findings.https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009200cervical squamous intraepithelial neoplasiaadenocarcinoma in situdiagnosiscolposcopyglandular and epithelial neoplasiashigh grade squamous intraepithelial neoplasia
spellingShingle Giselle Fachetti-Machado
Rosane Ribeiro Figueiredo-Alves
Marise Amaral Rebouças Moreira
Rita Maira Zanine
Maria José de Camargo
Eliana Pereira dos Reis
Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias
Clinical and Experimental Obstetrics & Gynecology
cervical squamous intraepithelial neoplasia
adenocarcinoma in situ
diagnosis
colposcopy
glandular and epithelial neoplasias
high grade squamous intraepithelial neoplasia
title Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias
title_full Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias
title_fullStr Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias
title_full_unstemmed Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias
title_short Agreement among Colposcopists on the Identification of Three Digital Images More Frequently Seen in Glandular Cervical Precursor Neoplasias
title_sort agreement among colposcopists on the identification of three digital images more frequently seen in glandular cervical precursor neoplasias
topic cervical squamous intraepithelial neoplasia
adenocarcinoma in situ
diagnosis
colposcopy
glandular and epithelial neoplasias
high grade squamous intraepithelial neoplasia
url https://www.imrpress.com/journal/CEOG/50/9/10.31083/j.ceog5009200
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