Multiple biopsies increase sensitivity of colposcopy

Physicians should consider collecting additional biopsies during colposcopy if multiple lesions are present, according to the authors of a study finding the practice increases the detection of high-grade squamous intraepithelial lesions.

An observational study of 690 women referred to colposcopy after abnormal cervical cancer screening results found sensitivity for detecting high-grade squamous intraepithelial lesions (HSILs) increased from 60.6% with a single biopsy to 85.6% with two biopsies and 95.6% with three biopsies.

“The incremental benefit of taking multiple biopsies was present regardless of referral cytology, HPV-16 status, and colposcopic impression; for example, even when there was a high-grade colposcopic impression, a single biopsy did not identify a prevalent HSIL in 35% of the women,” wrote Dr. Nicolas Wentzensen of the National Cancer Institute, Bethesda, Md., and colleagues.

Researchers found an increase in sensitivity of multiple biopsies across a range of subgroups, although the additional biopsies found more disease among women with more severe referral cytology, higher-risk HPV status, and higher-risk colposcopic impression, according to the study, published online Nov. 24 in the Journal of Clinical Oncology [doi:10.1200/JCO.2014.55.9948].