Correlation and concordance between oncotic colpocytology, colposcopy and histopathological analysis of cervical lesions identified at a brazilian reference teaching hospital

Objectives: The main objective of this study is to evaluate the correlation and agreement between the results of screening and diagnostic methods for cervical cancer. Methods: This retrospective observational study analyzed 185 medical records of patients who underwent conization between January 2022 and June 2024 to assess the diagnostic approach for cervical cancer. Patients had indications for colposcopy due to abnormal cytopathological results, history of cervical neoplasia, visible lesions, friable ectopia or postcoital bleeding. Records with colposcopic reports inconsistent with the latest international terminology were excluded. Results: Results were standardized using binary coding (0 = low-grade; 1 = high-grade), and the sample was divided into two groups: the “Concordant” group, comprising patients with a sum value of zero or four, and the “Discordant” group, including those in which at least one of the four tests disagreed with the others. The “Discordant” group included 96 patients (51.9%), while the “Concordant” group had 89 patients. Age distribution was similar between groups, allowing retention of the null hypothesis. All patients with low-grade cytopathology failed to achieve concordance, with the greatest disagreement between cytopathology and colposcopy-directed biopsy: 39 out of 40 of these patients had high-grade histopathology. Conversely, 89 of 145 patients with high-grade cytopathology had full agreement across all tests (χ² = 0.000; p < 0.001). Conclusions: Overall, 48.1% of patients had successful diagnosis with all results in agreement and classified as high-grade. The remaining cases, including all low-grade cytopathology patients, experienced diagnostic failure. Age was not a determining factor in diagnostic disagreement.