Frequency of Cervical Intraepithelial Neoplasia in Symptomatic Women with Clinically Unhealthy Cervix Based on Colposcopic Assessment

Abstract

Background: Cervical intraepithelial neoplasia (CIN) represents a precursor to invasive cervical cancer and remains a major public health concern, particularly in low-and middle-income countries where screening programs are limited. Aim: To determine the frequency of cervical intraepithelial neoplasia in symptomatic women with a clinically unhealthy cervix using colposcopic assessment and Reid scoring. Methods: This descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Gulab Devi Hospital, Lahore, over a period of six months, from October 2025 to March 2026. A total of 223 symptomatic women aged 20–70 years with clinically unhealthy cervix were included using non-probability consecutive sampling. Data on demographic, clinical, and reproductive characteristics were collected. Colposcopic examination was performed using 5% acetic acid and Lugol’s iodine, and CIN was diagnosed based on Reid Colposcopic Index scores. Data were analyzed using SPSS version 26.0, with appropriate descriptive and inferential statistics applied. Results: The mean age of participants was 38.6 ± 9.4 years. CIN was identified in 61.4% (n=137) of women, with 57.7% having low-grade and 42.3% having high-grade lesions. Abnormal vaginal discharge (36.8%) was the most common presenting symptom. Significant associations were observed between CIN and age (p=0.003), age at first pregnancy (p=0.001), duration of symptoms (p=0.002), contact bleeding (p=0.001), and visible cervical lesions (p<0.001). Logistic regression analysis identified age (OR 1.04), symptom duration (OR 1.09), contact bleeding (OR 2.41), and visible lesions (OR 3.76) as independent predictors of CIN. Conclusion: There is a high burden of CIN among symptomatic women with clinically unhealthy cervix, with significant clinical predictors identifiable through colposcopic assessment. Early detection using colposcopy can play a crucial role in preventing progression to invasive cervical cancer.