Cervicography

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Cervicography
PurposeTest for cervical cancer (screening)

Cervicography is a diagnostic medical procedure in which a non-physician takes pictures of the cervix and submits them to a physician for interpretation. Other related procedures are speculoscopy and colposcopy. The procedure is considered a screening test for cervical cancer and is complementary to Pap smear. The technique was initially developed by Adolf Stafl, MD, of Medical College of Wisconsin in 1981. [1]

Unlike colposcopy, cervicography does not have a current CPT/HCPCS code and typically is not covered by most medical insurance companies. (Cervicography was given a Category III CPT code of 0003T, but this was discontinued in 2006. [2] )

Cervicography is no more sensitive than Pap smear screening, and has a higher false positive rate (thus increasing the number of colposcopies needed). [3] [4]

Whether cervicography could have a role in countries where Pap smear screening programs are not in place depends on cost effectiveness and remained to be determined as of 1998. [4] A 2005 study found the sensitivity and specificity of cervicography for cervical intraepithelial neoplasia to be 72.3% and 93.2% respectively; [5] however, a 2007 study criticized the sensitivity figure as "likely... inflated" because the "gold standard" of colposcopy/biopsy may have missed cases of cervical intraepithelial neoplasia. [6]

References

  1. ↑ Stafl A (April 1981). "Cervicography: a new method for cervical cancer detection". Am. J. Obstet. Gynecol. 139: 815–25. PMID   7211987.
  2. ↑ "Cervicography". Archived from the original on 2011-07-24. Retrieved 2011-06-18.
  3. ↑ Nuovo J, Melnikow J, Hutchison B, Paliescheskey M (1997). "Is cervicography a useful diagnostic test? A systematic overview of the literature". J Am Board Fam Pract. 10: 390–7. PMID   9407479.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  4. 1 2 van Niekerk WA, Dunton CJ, Richart RM; et al. (1998). "Colposcopy, cervicography, speculoscopy and endoscopy. International Academy of Cytology Task Force summary. Diagnostic Cytology Towards the 21st Century: An International Expert Conference and Tutorial". Acta Cytol. 42: 33–49. PMID   9479322.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  5. ↑ De Vuyst H, Claeys P, Njiru S, Muchiri L, Steyaert S, De Sutter P, Van Marck E, Bwayo J, Temmerman M (May 2005). "Comparison of pap smear, visual inspection with acetic acid, human papillomavirus DNA-PCR testing and cervicography". Int J Gynaecol Obstet. 89 (2): 120–6. doi:10.1016/j.ijgo.2005.01.035. PMID   15847874.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. ↑ Pretorius RG, Bao YP, Belinson JL, Burchette RJ, Smith JS, Qiao YL (Nov 2007). "Inappropriate gold standard bias in cervical cancer screening studies" (PDF). Int J Cancer. 121 (10): 2218–24. doi:10.1002/ijc.22991. PMID   17657715.{{cite journal}}: CS1 maint: multiple names: authors list (link)
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