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 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 Comparison of diagnostic accuracy of papanicoloau (PAP) Smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma, taking biopsy as gold standard.

2020 ◽  
Vol 27 (04) ◽  
pp. 863-869
Author(s):  
Shakila Yasmin ◽  
Tahira Munir ◽  
Ayesha Javaid ◽  
Khalid Fahim Yasin ◽  
Junaid Hassan
Keyword(s):  
Acetic Acid ◽  
Diagnostic Accuracy ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
False Negative ◽  
True Positive ◽  
True Negative ◽  
Sensitivity Specificity

Study Design: Cross-sectional descriptive study. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital, Bahawalpur. Period: 05 August 2016 to 05 Feb 2017. Material & Methods: A total of 228 suspected patients of cervical carcinoma and age of 20-50 years were included. Patients with acute cervicitis, pregnant females, h/o abnormal cytology and obvious lesion on cervix were excluded. All the patients were underwent papanicoloau (PAP) smear and visual inspection using acetic acid. The results of papanicoloau (PAP) smear and visual inspection using acetic acid (VIA) were compared with cervical biopsy report. Results: In 110 papanicoloau (PAP) smear positive patients, 97 were True Positive and 13 were False Positive. Among, 118 papanicoloau (PAP) smear negative patients, 18 were False Negative whereas 100 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of papanicoloau ( PAP )smear in screening of cervical carcinoma was 84.35%, 88.50%, 88.18%, 84.75% and 86.40% respectively. In 114 visual inspection using acetic acid (VIA) positive patients, 95 were True Positive and 19 were False Positive. Among, 114 visual inspection using acetic acid (VIA) negative patients, 20 were False Negative whereas 94 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of visual inspection using acetic acid ( VIA) in  screening of cervical carcinoma was 82.61%, 83.19%, 83.33% 82.46% and 82.89% respectively. Conclusion: This study concluded that papanicoloau ( PAP) smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma are highly sensitive, accurate and having almost equal diagnostic accuracy.

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.

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 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 Evaluation of visual inspection with acetic acid (VIA), Lugol's iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America: This report refers to partial results from the LAMS (Latin AMerican Screening) study

2005 ◽  
Vol 12 (3) ◽  
pp. 142-149 ◽  
Author(s):  
L O Sarian ◽  
S F Derchain ◽  
P Naud ◽  
C Roteli-Martins ◽  
A Longatto-Filho ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Latin American ◽  
Visual Inspection ◽  
Pap Smear ◽  
Cervical Screening ◽  
Screening Tools ◽  
Predictive Values ◽  
Lugol’S Iodine ◽  
Cervical Disease ◽  
Sensitivity Specificity

Objectives: To assess the performance indicators of visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) in four Latin American centres participating in the ongoing Latin AMerican Screening (LAMS) study, in settings with moderate incidence of cervical disease and with poorly to moderately well-organized cervical cancer screening. Setting: Three Brazilian centres (São Paulo, Campinas and Porto Alegre) and one Argentine centre (Buenos Aires) recruited a total of 11,834 healthy women to undergo VIA, VILI, conventional Pap smear and Hybrid Capture II (HCII). Methods: Women who had a positive result from any of these tests were subjected to colposcopy and biopsies (if necessary), and women with high-grade cervical intraepithelial neoplasia (CIN) were properly treated. To control for verification bias, 5% of women with normal tests were referred for colposcopy, as were 20% of HCII-negative women. Results: Data on VIA ( n=11,834), VILI ( n=2994), conventional Pap smear ( n=10,138) and HCII ( n=4195) were available for test comparisons, calculating sensitivity, specificity, and positive and negative predictive values. Overall test positivity was 11.6% for VIA, 23.0% for VILI, 2.2% for Pap smear (LSIL threshold), 1.1% for Pap smear (HSIL threshold) and 17.1% for HCII. VIA was positive in 61.8% of the women with CIN 1, 57.0% of those with CIN 2, 35.0% of women with CIN 3 and in 21 of 28 (75%) of women with cancer. Approximately 10% of women with no detectable disease had an abnormal VIA. Regarding VILI, 83.3% of women diagnosed with CIN 1 and 62.5% of those with CIN 3 had an abnormal test. VILI failed to detect one of three cases of cancer. Both the sensitivity, specificity and positive predictive value of VIA and VILI in detecting CIN 2 or CIN 3 could be significantly improved depending on the combination with Pap smear or HCII (sensitivity up to 100.0% and specificity up to 99.8%). Conclusions: The LAMS study failed to reproduce the performance figures obtained with VIA and VILI (as stand-alone tests) in some other settings, where the prevalence of cervical disease was higher. However, a combined use of VIA or VILI with the Pap test or HCII allowed specific detection of cervical abnormalities.

scholarly journals Correlation of visual inspection with cytological and histopathological findings in cervical neoplasia

2017 ◽  
Vol 7 (1) ◽  
pp. 1070-1073 ◽  
Author(s):  
P Sherpa ◽  
AD Pant
Keyword(s):  
Acetic Acid ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Invasive Carcinoma ◽  
Intraepithelial Neoplasia ◽  
Cervical Neoplasia

Background: Cervical cancer is one of the commonest malignancies and a leading cause of morbidity and mortality among women. The aim of this study was to evaluate the diagnostic value of Papanicolaou (PAP) smear and visual inspection with acetic acid as methods of cervical cancer screening.Materials and Methods: This was a observational cross-sectional study conducted from the period of 2068.11.01 to 2069.11.01. The study population consisted of women with histologically confirmed cervical intraepithelial neoplasia or invasive carcinoma who had undergone prior PAP smear.Results: During the study period 160 patients underwent both PAP smear and cervical biopsy. Of these patients, 49 had a histological diagnosis of cervical intraepithelial neoplasia or invasive carcinoma. The histopathological and cytological diagnoses were compared. Visual inspection with acetic acid status was available for 31 of the 49 cases. The sensitivity of PAP smear was 61%, specificity 97%, positive predictive value 91%, negative predictive value 85% and diagnostic accuracy 86% for detection of cervical neoplasia. Visual inspection with acetic acid had a sensitivity of 74%, specificity 48%, Positive predictive value 64%, Negative predictive value 60% and diagnostic accuracy of 63%. Combining the two procedures increased sensitivity by 26%, Negative predictive value by 11%  and diagnostic accuracy by 2 per cent.Conclusion: PAP smear has a higher specificity, Positive predictive value, Negative predictive value and diagnostic accuracy but lower sensitivity than visual inspection with acetic acid. Visual inspection with acetic acid by itself is not an effective screening method. A combination of PAP smear and visual inspection with acetic acidcan ensure adequate screening of cervical neoplasia.

scholarly journals Visual Inspection with Acetic Acid-an Acceptable Option in Screening of Cervical Cancer.

2018 ◽  
Vol 24 (S) ◽  
pp. 879-883
Author(s):  
Summera Aslam ◽  
Ahmed Zunair Wasim ◽  
Lubna Javed ◽  
Tayyiba Wasim
Keyword(s):  
Acetic Acid ◽  
Cervical Carcinoma ◽  
Visual Inspection ◽  
Pap Smear ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Screening Tests ◽  
Cross Sectional ◽  
Predictive Values ◽  
Sensitivity Specificity

Objectives| To evaluate the accuracy of Visual Inspection with Acetic Acid (VIA) and Papanicolaou (Pap) smear as screening tests for cervical carcinoma and compare it with cervical biopsy as a gold standard. Methods| This was a cross-sectional study conducted at Gynae Unit 3 Services Institute of Medical Sciences from Jan 2016 to December 2016. All the married patients between 18 to 64 years of age were included in the study. Every patient underwent VIA, Pap smear and colposcopic directed biopsy from aceto white area as well as from 2:00 clock and 5:00 clock position. We determined the sensitivity, specificity, positive and negative predictive values of VIA, Pap smear and both tests and compared them with histopathology of biopsy specimen. Results| 476 women were screened in the study. Out of these, 110 (23.10%) patients were VIA positive and 40 (8.40%) patients were positive with Pap smear. Thirty seven (7.77%) patients were positive on both VIA and Pap smear. A total of 43 (9.03%) patients had cervical pre-malignancy on biopsy. The sensitivity of VIA and pap was 97.67%, 94.87% while specificity was 84.29% and 99.31%respectively (p=0.001). The PPV of VIA and pap was 38.18% and 92.5 %( p=0.00) while NPV was 99.7% and 99.5% respectively. The sensitivity and specificity of both tests combined was 94.59% and 99.54% while the PPV and NPV was 94.59% and 99.54% respectively. Diagnostic accuracy of VIA was 85.5%. Conclusion| VIA has high sensitivity and NPV which makes it an effective screening test for cervical carcinoma in developing countries like Pakistan. Pap smear can be combined to VIA positive cases to improve its specificity.

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