Correlation of Colposcopic Findings with Histologic Diagnosis in Cervical Lesions at Federal Medical Centre, Abuja

Background: Early detection and treatment remain a key strategy for the eradication of cervical-cancer-related morbidities and mortalities. The overtreatment attributed to see and treat using visual inspection with acetic acid (VIA) or lugol’s iodine (VILI) and delays in commencement of treatment for premalignant and micro-invasive lesions attributed to histology waiting time, both underscore the need for other reliable diagnostic alternatives. Colposcopy is an invaluable tool for the assessment and management of cervical premalignant, micro-invasive and early malignant lesions. Reid’s colposcopic index (RCI) has been reported to accurately predict the histologic grading of cervical lesion, which is the definitive diagnosis. Aims: This study aimed to evaluate the accuracy of colposcopic findings using Reid’s Colposcopic Index (RCI) in predicting the histological diagnosis of cervical lesions at the Federal Medical Centre Abuja. Materials and Methods: This nine-year retrospective comparative study analyzed colposcopy-directed biopsies and their corresponding histological diagnoses from August 6, 2015, to August 5, 2024, at Federal Medical Centre Abuja. Cases meeting inclusion criteria were identified from colposcopy and histopathology clinic records. The RCI scoring system was compared with histologic diagnoses. Data were analyzed using Epi Info version 7.2.6.0 (2023), employing descriptive statistics and Kappa statistics to assess the level of agreement between colposcopic and histological findings. Results: Of the 304 colposcopies performed, 145 cases met the study criteria. The median age was 43 years, with most patients being multiparous and having tertiary education. The primary indication for colposcopy was an abnormal Pap smear (51.72%). Colposcopic impressions using RCI showed a high accuracy, with benign conditions correctly identified in 94.03% of cases. The overall sensitivity of colposcopy for CIN I, CIN II, CIN III, and microinvasive carcinoma ranged from 75% to 90%, while specificity ranged from 88.6% to 100%. The Kappa value for agreement between colposcopic impressions and histological diagnoses was 0.76, indicating substantial agreement Conclusions: The study demonstrated a strong correlation between RCI-based colposcopic impressions and histological diagnoses, affirming its accuracy in assessing cervical lesions. These findings support the use of colposcopy with RCI as an effective diagnostic tool, particularly in settings with limited access to histopathological services. This approach may enhance the quality of cervical cancer screening and management in resource-limited environments.