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Digital Assessment of the Reproductive Tract Versus Colposcopy for Directing Biopsies in Women With Abnormal Pap Smears

Cremer, Miriam L. MD, MPH1,2; Peralta, Ethel I.2; Dheming, Selma G. MD3; Jimenez, Maria E. MD3; Davis-Dao, Carol A. MS4; Alonzo, Todd A. PhD5; Blumenthal, Paul D. MD, MPH6; Felix, Juan C. MD5

Journal of Lower Genital Tract Disease: January 2010 - Volume 14 - Issue 1 - p 5-10
doi: 10.1097/LGT.0b013e3181a02058
Spanish Translation

Objective: This study aimed to compare digital camera assessment of the reproductive tract (DART) to colposcopy for the evaluation of abnormal Pap smears.

Materials and Methods: Participants included 207 women with abnormal Pap smears. Colposcopy and DART were performed on each patient by separate examiners with the goal of lesion detection. Analysis was performed per patient and per biopsy.

Results: Patients had an average of 2.9 biopsies. Forty-two patients and 81 biopsies were positive for cervical intraepithelial neoplasia 2+. Both DART and colposcopy detected 41 (97.6%) of 42 patients (95% CI = 85.9%-99.9%). Digital camera assessment of the reproductive tract detected 66/81 (81.4%; CI = 70.7%-88.9%) and colposcopy detected 69/81 (85.2%; CI = 73.2%-92.4%) of biopsies that were cervical intraepithelial neoplasia 2+.

Conclusions: Digital camera assessment of the reproductive tract detects high-grade lesions of the cervix with similar sensitivity to colposcopy. It holds great promise to expand cervical cancer precursor lesion detection in areas with limited resources.

Digital assessment of the reproductive tract is a new, low-technology method, with similar sensitivity to colposcopy, to aid in directing cervical biopsies in women with abnormal Pap smears.

1New York University School of Medicine, New York City, NY; 2Basic Health International; 3Instituto del Cancer de El Salvador, San Salvador, El Salvador; 4Department of Preventive Medicine, 5Keck School of Medicine, University of Southern California, Los Angeles, CA; 6Johns Hopkins University School of Medicine, Baltimore, MD

Reprint requests to: Miriam L. Cremer, MD, MPH, Bellevue Hospital, New York University School of Medicine, 462 1st Avenue, NBV 9E2, New York, NY 10016. E-mail:

This study was funded by Basic Health International. Colonia las Mercedes Avenida los Espliegos #5, San Salvador, El Salvador.

©2010The American Society for Colposcopy and Cervical Pathology