Patients with higher rieds index have increased chances of cervical dysplasia: Study
Cervical cancer is the third most common cancer in women worldwide. Despite the fact that maximum number of cervical cancer cases are in developing countries, only 5% of women have ever been screened as compared with 40-50% of women in developed countries. Preventing invasive cancer through early detection and treatment of cervical intraepithelial neoplasia is currently the most cost-effective, long-term strategy for controlling cervical cancer.
The major factor contributing to decline of incidence of cervical cancer in developed countries is early detection and treatment of precancerous cervical lesions as a part of routine gynaecological care. Cervical cancer has a prolonged inactive period and can be effectively avoided through early detection utilizing different screening methods such as Pap smear, HPV DNA testing, visual inspection with acetic acid, and visual inspection with Lugol’s iodine. Nevertheless, colposcopy remains the gold standard for evaluating the accuracy of all screening methods. Primary issues experienced during colposcopy include insufficient expertise, challenges in interpretation, discrepancies, and non-adherence to established diagnostic protocols.
The incidence of cervical cancer has decreased by more than 50% in the past 30+ years, due to the increasing use of cervical cancer screening with cervical cytology. Papanicolaou test, also known as the Pap test or the Pap smear. Pap smear is an integral part of the comprehensive health care of women. Pap smear test is a secondary preventive method aimed at identification of premalignant and malignant lesions, which may need follow-up and/ or treatment. Reid and Scalzi proposed the Reid colposcopic index (RCI) to make colposcopic diagnosis less subjective relies on critical analysis rather than on pattern recall. The Reid colposcopic index (RCI) is a systematic and objective method of colposcopically grading the severity of premalignant lesions of cervix. The index considers four colposcopic signs: lesion margin, colour of acetowhitening, blood vessels and iodine staining.
It was prospective observational study in 88 patients attending gynaecology opd. Out of 88 patients, 13 patients were lost in follow up after Pap smear. In result, there were 10 patient’s with reids index 8 to 10 and 7 patients in her histopathology showed High grade intraepithelial neoplasia that is CIN 2, 3.
The sociodemographic parameters of present study were very much similar to that of other studies. In the present study, authors included women 21 to 60 year age and most of them belong to 3rd and 4th decade and this age was comparable to other study. In this study, most of the patient presented to opd with complain of discharge per vaginum, pain abdomen and abnormal uterine bleeding.
This study directly correlate that higher the reids colposcopic index, higher the chances of cervical dysplasia. So colposcopy could be better adjunctive tool with Pap smear in low resource setting.
Source: Chandanan et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(2):283–286
