Cervicography

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. Cervicography: a new method for cervical cancer detection. Am J Obstet Gynecol. 1981 Apr 1;139(7):815-25. PMID 7211987
2. ^ https://www.bcidaho.com/providers/medical_policies/med/mp_20404.asp
3. ^ Nuovo J, Melnikow J, Hutchison B, Paliescheskey M. Is cervicography a useful diagnostic test? A systematic overview of the literature. J Am Board Fam Pract. 1997 Nov-Dec;10(6):390-7. PMID 9407479
4. ^ ^{a b} van Niekerk WA, Dunton CJ, Richart RM, Hilgarth M, Kato H, Kaufman RH, Mango LJ, Nozawa S, Robinowitz M. 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. 1998 Jan-Feb;42(1):33-49. PMID 9479322
5. ^ De Vuyst H, Claeys P, Njiru S, Muchiri L, Steyaert S, De Sutter P, Van Marck E, Bwayo J, Temmerman M. Comparison of pap smear, visual inspection with acetic acid, human papillomavirus DNA-PCR testing and cervicography. Int J Gynaecol Obstet. 2005 May;89(2):120-6. PMID 15847874
6. ^ Pretorius RG, Bao YP, Belinson JL, Burchette RJ, Smith JS, Qiao YL. Inappropriate gold standard bias in cervical cancer screening studies. Int J Cancer. 2007 Nov 15;121(10):2218-24. PMID 17657715