Diagnostic Value of Papanicolaou Smear versus Colposcopy in Reproductive age Women with Clinically Unhealthy Cervix: A Narrative Review

Cervical cancer is the second most common cancer among Indian women, and timely detection of premalignant lesions is key to reducing its burden.The Papanicolaou (Pap) smear and colposcopy are two widely used methods for the same. However, the diagnostic performance of each method varies significantly, particularly in symptomatic or high-risk populations. Pap smears offer a low-cost, specific screening tool, while colposcopy is a resource-intensive procedure that requires trained specialists. Colposcopy has demonstrated higher sensitivity and correlation with histopathological outcomes than the Pap smear in high-risk women. A combined approach, especially in symptomatic women, may improve early detection rates. This narrative review evaluates the diagnostic role of Pap smear and colposcopy in reproductive-age women with a clinically unhealthy cervix, with emphasis on their accuracy, limitations, and complementary use.