Interobserver agreement on interpreting hand drawings of colposcopy in women with borderline cytology to predict high-grade lesions

Objective: To assess the interobserver agreement on interpreting hand drawings as a colposcopic image recording technique in women with borderline cytology and to assess the correlation between colposcopic impression and histological outcome. Methods: We used colposcopic documentation and histology from a cohort study of women with borderline dyskaryosis. Four gynecologists and four residents scored the same 30 colposcopic documentation forms. Results: There is a good interobserver agreement on classifying colposcopic hand drawings as high-grade lesions (average kappa 0.58). The interobserver agreement on interpreting colposcopic image was higher for the more highly experienced gynecologists than for the residents. The agreement between colposcopic impression and histological outcome is poor (kappa 0.17) among the observers. Conclusions: Hand drawings are a reliable recording technique of interpreting colposcopic impression documented as high-grade lesion. However, the correlation between colposcopic impression and histological outcome is still poor in women with minor cytological abnormalities.