Preliminary comparison of papanicolaou smear and speculoscopy for assessing cervical cancer precursor lesions in pregnant adolescents

Background: The objective of this study was to assess the efficacy of speculoscopy in screening pregnant adolescents for abnormal cervical pathology. Methods: This was a prospective comparative study of the Papanicolaou smear and speculoscopy in pregnant adolescents (<17 years of age at the time of examination) presenting for their initial obstetric visits. This study was conducted at private offices of a general obstetrics and gynecology academic practice. Interventions included Papanicolaou smears and speculoscopic examinations; patients with a positive result for either intervention were offered colposcopy. Main outcome measures were Papanicolaou smear and speculoscopy outcomes and results of colposcopy and cervical biopsies. Results: Thirty consecutive pregnant adolescents were included in the study. Papanicolaou smears and speculoscopic examinations were well tolerated by all adolescents. Twentyone adolescents had negative Papanicolaou smears and speculoscopic examinations, and one woman had a positive Papanicolaou smear and a negative speculoscopic examination. Four adolescents had positive speculoscopic examinations and negative Papanicolaou smears; of these cases, significant pathology was found in one case. Four adolescents had positive Papanicolaou smears and speculoscopic examinations, with significant pathology in two of these adolescents. Conclusion: This preliminary study shows speculoscopy to be well tolerated, not causing cervical trauma, and as effective as the Papanicolaou smear for detecting cervical pathology in pregnant adolescents.