scholarly journals Comparative efficacy of visual inspection with acetic acid versus cytology for cervical cancer screening in Ogbomoso, Nigeria

2017 ◽  
Vol 6 (9) ◽  
pp. 3742
Author(s):  
Afolabi B. Abiodun ◽  
Aadewunmi O. Durodola ◽  
Mustapha A. Ajani ◽  
Isaac O. Amole ◽  
Adejoke D. Abiodun ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Statistical Significance ◽  
Cervical Lesion ◽  
World Health ◽  
Comparable Efficacy ◽  
Primary Screening

Background: Screening test for cervical cancer using visual inspection with acetic acid (VIA) has been advocated by World Health Organization as a suitable, low cost and feasible alternative modality for control of cervical cancer in resource-poor settings as compared to cytological and colposcopic screening. The need for reproducibility, accuracy and comparable efficacy will influence the acceptability of VIA as primary screening modalities for cervical cancer.Methods: A cross–sectional comparative study conducted at BUTH. Data were obtained from 318 consenting women aged 30–65 years using a systematic random sampling method and an interviewer–administered structured questionnaire. Pap smear samples were taken followed by visual inspection with acetic acid. Using Statistical Package for Social Sciences (SPSS) version 23.0, Frequencies were obtained and Chi-square test (X2) was used to compare rates and proportions with the level of statistical significance set at less than 0.05.Results: Positive results for premalignant cervical lesion was 1.3% and 4.1% for VIA and Pap smear respectively (X2=4.52; p=0.034). The sensitivity of VIA was 7.7% with positive predictive value of 25% while specificity was 99.0% with a negative predictive value of 96.2%. The prevalence of abnormal cervical lesion in the population studied was 4.1% (95% CI 2.2% – 6.9%).Conclusions: The detection rate for pre-cancerous lesions of the cervix using VIA was significantly lower than that of Pap smear in this study. There may be needed to exercise caution in adopting VIA as primary screening modality for cervical cancer.

scholarly journals Diagnostic Value of VIA Comparing with Conventional Pap Smear in the Detection of Colposcopic Biopsy Proved CIN

1970 ◽  
Vol 6 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Divya Hegde ◽  
Harish Shetty ◽  
Prasanna K Shetty ◽  
Supriya Rai ◽  
Lakshmi Manjeera ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
High Grade ◽  
Low Resource Settings ◽  
Low Resource

Aim: A study to assess the role of visual inspection with acetic acid VIA as an alternative to Pap smear in screening program for cervical cancer in low resource settings. Method: Two hundred and twenty five women in reproductive age group attending the Gynecology department at K.S Hegde Charitable Hospital were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All women then underwent colposcopy using the video colposcope. All patients who tested positive on screening then underwent colposcopy guided biopsy. Pap smear of Low grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was chi square test and results were computed using Statistical Package for the Social Sciences (SPSS) version 12.0. Results: Out of 225 patients, VIA was positive in 27(12%) patients and Pap smear was abnormal in 26(11.7%). There were 15 LSIL, 6 high Grade Squamous intraepithelial lesions (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia and 3 squamous cancers. Pap smear had a sensitivity of 83%, specificity of 98%, and positive predictive value of 80 % and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9 % and negative predictive value of 96.5%. Conclusion: Since diagnostic values of VIA is comparable to Pap smear, and it performs well in detecting high grade lesion we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings. Keywords: Cervical cancer in low resource settings, Pap smear- colposcopy, visual inspection with acetic acid   DOI: http://dx.doi.org/10.3126/njog.v6i1.5245 NJOG 2011; 6(1): 7-12

scholarly journals VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

2017 ◽  
Vol 7 (1) ◽  
pp. 210
Author(s):  
Anita Paswan ◽  
Anil Kumar ◽  
Kumudini Jha ◽  
Shail Kumari Sinha
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Lugol’S Iodine ◽  
Resource Setting ◽  
Sensitivity Specificity

Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.

scholarly journals Diagnostic value of VIA comparing with conventional pap smear in the detection of colposcopic biopsy proved CIN

1970 ◽  
Vol 9 (3) ◽  
pp. 134-139
Author(s):  
D Hegde ◽  
H Shetty ◽  
PK Shetty ◽  
S Rai ◽  
L Manjeera ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Low Resource Settings ◽  
Low Resource ◽  
Intraepithelial Lesion

Introduction: Cervical cancer, the leading malignancy among Indian women is preventable and curable if detected at an early stage using proper screening tools. We conducted a study to assess the role of visual inspection with acetic acid as an alternative to pap smear and in screening program for cervical cancer in low resource settings. Methods: Two hundred and twenty five women in reproductive age group attending the Gynecology department at K.S Hegde Charitable Hospital were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All women then underwent colposcopy using the videocolposcope. All patients who tested positive on screening then underwent colposcopy guided biopsy. Pap smear of low grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was chi square test and results were computed using SPSS version 12.0. Results: Out of 225 patients, VIA was positive in 27(12%) patients and pap smear was abnormal in 26(11.7%). There were 15 LSIL, 6 high grade squamous intraepithelial lesion (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia and 3 squamous cancers. Pap smear had a sensitivity of 83%, specificity of 98%, positive predictive value of 80 % and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9 % and negative predictive value of 96.5%. Conclusion : Since diagnostic values of VIA is comparable to pap smear, and it performs well in detecting high grade lesion we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings. Keywords: visual inspection with acetic acid; pap smear- colposcopy; cervical cancer; low resource settings DOI: http://dx.doi.org/10.3126/hren.v9i3.5579   HR 2011; 9(3): 134-139

scholarly journals Effectiveness of Visual Inspection with Acetic Acid versus Papanicolaou Smear for Cervical Cancer Screening at Kirtipur Hospital

2017 ◽  
Vol 11 (2) ◽  
pp. 28-31
Author(s):  
Peru Pradhan ◽  
Sona Shrestha ◽  
Ganesh Dangal ◽  
Kabin Bhattachan
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Lower Abdominal Pain ◽  
Suitable Alternative ◽  
History Of ◽  
Cervical Cells ◽  
Age Range

Aims: The aim of this study was to compare the accuracy of detecting precancerous cervical cells, via a visual inspection of the cervix and an application of acetic acid (VIA) with the Papanicolaou (Pap) smear,to screen for cervical cancer in resource poor countries.Methods: The study involved 189 women between the ages of 30-60 years, who attended the Gynaecological Out Patient Department at Kirtipur hospital from 1st December 2014 to 31st March 2015. A VIA and Pap smear was done in all women, with cervical biopsies conducted in VIA positive women.Results: Themajority of these women were in the age range of 30-39 years, non-smokers, housewives, multipara and non-users of contraception. Of the tested group 8 (4.2%) had a history of post coital bleeding, 64 (21.2%) presented with lower abdominal pain, 64 (33.9%) presented with suspected abnormal vaginal discharge and 34 (17.98%) with dysfunctional uterine bleeding. Out of 189 women the VIA was positive in 5 (2.62%) and a Pap smear was positive in 2 (1.1%). Bycomparison to a Pap smear the VIA has an accuracyof 100%, specificity 98.4%, positive predictive value 40% and negative predictive value 100%.Conclusions: A visual inspection of the cervix with acetic acid performed by a qualified physician is a suitable alternative for precancerous cell screening in low resource settings.

scholarly journals The Utility of Visual Inspection with Acetic Acid in Cervical Cancer Screening

2017 ◽  
pp. 7-14
Author(s):  
Chidi Okorie Onwuka ◽  
Ima-Obong A. Ekanem
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Cancer Screening ◽  
Negative Predictive Value ◽  
Cervical Cancer Screening ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Screening Methods ◽  
Cancer Management

Objective: Cervical cancer is potentially preventable but still remains a leading cause of cancer mortality in in developing countries like Nigeria. Cytology-based screening programmes are difficult to maintain in these countries. Developing a cheap and reliable alternative is an important public health measure in these regions. This study was carried out to compare the utility of VIA and Pap smear as Cervical cancer screening methods in HIV-infected and non HIV-infected women. Methodology: Between March, 2013 and March, 2014, 461 consenting women, comprising 231 HIV positive women (HPW) and 230 HIV negative women (HNW) were recruited and screened for cervical cancer using conventional Pap smear and VIA simultaneously in University of Uyo Teaching Hospital. The Pap smear findings were classified using the 2001 Bethesda system. Patients with a positive Pap smear or abnormal VIA findings were recalled for biopsy. The results of the two tests were compared using biopsy as the gold standard. Results: The overall sensitivity, specificity, positive predictive value and negative predictive value for VIA were 100%,80%,76.9%, and 100%, respectively compared to 80%, 100%, 100%, and 88.2% for conventional Pap smear. Visual inspection of the cervix with acetic acid for cervical cancer screening is not specific but has a high negative predictive value. Conclusion: This study does not support a “see-and-treat” approach in cervical cancer management using VIA only. In resource-challenged areas, VIA can be applied on a large scale basis in primary screening for cervical cancer so as to triage, women who will benefit from further evaluation before applying the appropriate treatment.

scholarly journals Comparative evaluation of test characteristics of acetic acid, lugol’s iodine and toluidine blue stains in cervical cancer screening

2017 ◽  
Vol 6 (11) ◽  
pp. 4857
Author(s):  
Ankita Kumari ◽  
Neha Singh ◽  
Shaila Mitra ◽  
Reena Srivastav
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Toluidine Blue ◽  
Visual Inspection ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
Signs And Symptoms ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Lugol’S Iodine

Background: Cervical cancer rank second in female cancer and India alone account for one fourth of the global cervical cancer burden. The study was aimed to evaluate the diagnostic efficacy of acetic acid (3%), lugol’s iodine and toluidine blue (1%) in detection of abnormal cervical lesions.Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur over a period of one year from July 2016 to June 2017. The study included 200 women in age group 20-60 years with signs and symptoms suspicious of abnormal cervical lesion. The cases were subjected to detailed history, clinical examination, Pap smear, Visual inspection test, colposcopy followed by cervical biopsy.Results: Out of total 200 patients, 114 patients had acetowhite area on VIA (visual inspection with acetic acid) test, 113 were VILI (visual inspection with lugol’s iodine) positive and 107 women stained positive with Toluidine blue but only 88 showed biopsy proven pre-invasive and invasive lesions. So, sensitivity of acetic acid, lugol’s iodine and Toluidine blue was 81.8%, 84.09% and 90.9% respectively. Similarly, the specificity of the three stains were 62.5%, 65.17% and 75.8% respectively.Conclusions: Toluidine blue (1%) has proved to be significantly more sensitive and specific stain as compared to acetic acid (3%) and lugol’s iodine (50% dilution) in diagnosing pre-invasive and invasive cervical cancer. Hence, it may aid as an important tool in screening and treating precancerous and cancerous lesions.

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