Diagnostic Performance of Pap Smear for Cervical Intraepithelial Neoplasia in Women With Treatment-Resistant Vaginal Infections: A Colposcopy-Guided Biopsy Correlated Study Publisher



Peydayesh M ; Nikfar S ; Ghasemi K ; Zamani N
Source: Cancer Treatment and Research Communications Published:2026

Abstract

Background: The present study was conducted to investigate the value of Pap smear in the diagnosis of cervical intraepithelial neoplasia compared to colposcopy results in patients suffering from medication-resistant vaginal infection. Materials and methods: This is a retrospective diagnostic accuracy study was conducted on 975 female patients with medication-resistant vaginal infection who referred to our tertiary hospital between 2018 and 2023 and met the inclusion criteria. All demographic and clinical information, including Pap smear and colposcopy results, were extracted from the files and collected using a researcher-made questionnaire. All information was statistically analyzed using SPSS and MedCalc software. Results: The mean age of the patients was 34.63 ± 8.38 years. The most common cause of referral for colposcopy was treatment-resistant vaginal discharge (74.6 %). In Pap smear results, 33.2 % of cases were reported as normal. Also, mild, moderate, and severe inflammation were found in 12.1 %, 2.4 %, and 3.5 % of the cases, respectively. The high percentage of ASCUS, LSIL, and HSIL was 39.8 %, 5.3 %, and 1.3 %, respectively. In colposcopy, 38.7 %, 52.6 %, 7.5 %, and 1.2 % of the cases had cervicitis, CIN-1, CIN-2 and CIN-3, respectively. Also, Pap smear in CIN screening had a sensitivity, specificity, positive predictive value, and negative predictive value of 50.6 %, 54.1 %, 63.7 %, and 40.8 %, respectively. Discussion: Considering the low sensitivity and specificity of Pap smear results in diagnosing CIN lesions in women with treatment-resistant vaginal discharge, it is recommended to use complementary methods in addition to Pap smear. © 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/