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Diagnostic reliability of prebioptic methods in the prediction of a histological basis of cervical lesions and its correlation with accuracy of colposcopically directed biopsy in patients with cervical neoplasia.

OBJECTIVE
High incidence of cervical cancer in the Czech Republic leads us to look for an optimal model of screening. The evaluation of the realiability of prebiopsy (cytology and colposcopy) and of punch biopsy is an important diagnostic step.


MATERIAL AND METHODS
In a prospective study we examined 308 women detected by cytological screening who afterwards underwent surgery for a cervical lesion. Punch biopsy before the operation, most frequently by conization, was performed in every patient after assessing the prebioptic prediction (colposcopy and cytology).


RESULTS
Reliable cytological screening associated with good colposcopy permits a correct diagnosis with high reliability. The rate of errors which increase the risk (threatening of health or the life of women) was 2.9% by prebioptic methods (high reliability) and 4.4% by punch biopsy.


CONCLUSION
These good results are achieved in centers led by trained physicians and experts in cytology and skilled in colposcopy.