scholarly journals A comparison of cervical cancer screening methods: pap smear, liquid based cytology and VIA VILI

2019 ◽  
Vol 8 (5) ◽  
pp. 1738
Author(s):  
Abinaya Maathuri Jeyakumar ◽  
Swarnalatha Mohanapu
Keyword(s):  
Cervical Cancer ◽  
Visual Inspection ◽  
Pap Smear ◽  
Geographical Area ◽  
Screening Methods ◽  
Lower Sensitivity ◽  
Predictive Values ◽  
Advantages And Disadvantages ◽  
Liquid Based Cytology ◽  
Sensitivity Specificity

Background: There are multiple screening methods available for screening cervical cancer with their advantages and disadvantages, researches that compare the sensitivity, specificity, positive and negative predictive values of these tests in a low-cost setting specific to a geographical area is lacking and has to be enhanced. The objective of this study was to determine and compare the agreement, sensitivity, specificity and predictive values of conventional Pap smear cytology, liquid-based cytology and VIA/VILI with cervix biopsy.Methods: This cross sectional study was conducted on women of >35 years of age. Pap smear specimen was collected followed by Liquid Base Cytology (LBC) using cytobrush specimen after which visual inspection with 5% acetic acid (VIA) and visual inspection with Lugol’s Iodine (VILI) procedure was carried out and followed by cervix biopsy. All methods were analyzed for accuracy.Results: Sensitivity was lowest for PAP smear (39.1%, 95% CI 19.18% to 59.1%), followed by VIA VILI (95.7%, 95% CI 87.32% to 100%), and highest for LBC (100.0%). The negative predictive value was lowest for PAP smear (87.4%, 95% CI 81.21% to 93.6%), followed by VIA VILI (99.0%, 95% CI 96.99% to 100.0%) and highest for LBC (100%). The overall diagnostic accuracy was lowest for PAP smear (88.3%) followed by VIA/VILLI (99.2%) and highest for LBC (100%).Conclusions: Treatment decisions based on findings of the PAP smear have to be taken with caution, considering the lower sensitivity. Wherever resources are available more accurate screening methods like liquid-based cytology must be used.

scholarly journals A Comparative Study between Conventional Pap Smear and Liquid-Based Cytology: A Clinco-Cytological Study of Iraqi Women with Some Health Problems of Cervix

2019 ◽  
pp. 2362-2370
Author(s):  
Huda Hameed K. Alabbody ◽  
Zahraa Adnan G. Al-Ghuraibawi
Keyword(s):  
Cervical Cancer ◽  
Uterine Cervix ◽  
Visual Inspection ◽  
Pap Smear ◽  
Cervical Screening ◽  
Health Problems ◽  
Low Grade ◽  
Sexually Active ◽  
Iraqi Women ◽  
Liquid Based Cytology

A cervical screening by Pap test is necessary in recognizing precancerous and cancerous cases to reduce mortality due to cervical cancer among women. Regular screening and follow up can make it easier to early diagnose and eventually, to treat and control cervical cancer.     This study aimed to detect atypical pathological changes of the vagina and uterine cervix of a sample of Iraqi women by macro- and micro-examination, and to determine the link with the demographic features. Also the study aimed to evaluate the two Pap smear techniques; the conventional and the base liquid methods.      The study included 50 women with genital health problems (18-50 years old) who were referred to the National Cancer Research Center (NCRC), the University of Baghdad, during the period from 1st April to 30st of September 2018. Both visual inspection of the uterine cervix and Papanicolaou smear were performed for all of the participants.      The results showed that most patient women (96%) were married and sexually active, with 51% being married under 20 years of age .Visual inspection of the cervix showed that 30% of the women had translucent, opaque or erosion lesions. Upon cytology examination, 92% of the women showed nonspecific inflammation, 70% revealed reactive squamous metaplasia, 10% had Koilocytotic atypia, and 8% suffered from cervical intraepithelial neoplasia (CIN1) or low grade squamous intraepithelial lesion (LGSIL). Contraception was used by 82% of the patients, while 36% used pills. The causes of the referral to the centre were abnormal vaginal discharge (44%) and post-coital bleeding "and\or" dyspareunia (20% each). Lastly, 74% of the participants did not make this test previously. Liquid-based cytology technique outperformed conventional pap smears because of improved fixation, decreased impurities factors, and standardization of cell transfer.     We conclude that routine screening and Pap smear testing for uterine cervix and vagina might be useful to prevent the occurrence of precancerous lesions in the genital system of sexually active women. We recommend to apply this test before and after treatment and to activate the cellular examination in the basal fluid method

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 Correlating Pap Smear Results and Colposcopy-Directed Large Loop Excision of the Transformation Zone Histopathology in HIV-Infected and HIV-Uninfected Women: A Case-Control Study in South Africa

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Louis-J. van Bogaert
Keyword(s):  
Pap Smear ◽  
False Negative ◽  
Screening Methods ◽  
Cytological Diagnosis ◽  
Predictive Values ◽  
Transformation Zone ◽  
Large Loop ◽  
Cytological Abnormality ◽  
Sensitivity Specificity ◽  
Minimal Abnormality

Background. In low-resource settings (LRS) with high HIV/AIDS and cervical cancer rates, new screening strategies face many logistic hurdles. Since cytology is there to stay, at least in the median-term future, it is important to assess to what extent HIV-HPV coinfection impacts the accuracy of screening methods and strategies. Methods. We audited the correlation between cytological diagnosis of minimal abnormality (CIN1), CIN2+, or cancer and the histological diagnosis of colposcopy-directed large loop excision of the transformation zone of 399 HIV-uninfected controls and 389 HIV-infected cases. Results. The average age at diagnosis of CIN2+ of the cases was 4.2 years younger than controls (). The endpoint used to assess the accuracy of cytology was minimal cytological abnormality (≤CIN1/LGSIL). The sensitivity, specificity, and negative and positive predictive values were 92.7, 18.5, 45.1, and 77.9%, respectively. The overall ratio of discordance/concordance between cytology and histology was similar in both groups. Conclusion. In LRS, where rapid-HPV testing is not yet part of screening algorithms, a cytological diagnosis of minimal abnormality requires visual inspection and treatment of visualized lesions especially in HIV-infected women aged 30 years. The cytological endpoint of accuracy should be set low to avoid false negative smears.

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 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.

scholarly journals Evaluation of Abnormal Cervix with Visual Inspection under Acetic Acid and Colposcopy

2019 ◽  
Vol 17 (01) ◽  
pp. 76-79
Author(s):  
Kabin Bhattachan ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Low Income ◽  
Visual Inspection ◽  
Pap Smear ◽  
Histopathological Examination ◽  
Precancerous Lesion ◽  
Public Health Problem ◽  
Screening Methods ◽  
Major Public Health Problem

Background: Cervical cancer is a major public health problem especially in developing countries. It can be prevented through implementation of routine screening program. There are different screening methods but their efficacy are still questionable. So the purpose of this study is to evaluate the efficacy of visual inspection of cervix with acetic acid and colposcopy to detect precancerous lesion in women with clinically unhealthy or abnormal cervix.Methods: Forty patients with abnormal cervix (35) and abnormal pap smear results (5) were enrolled for the study in outpatient department of Kathmandu Model Hospital. Patients were evaluated with visual inspection of cervix with acetic acid and colposcopy in the same sitting. Cervical punch biopsy were taken from suspected lesion or from four quadrant if colposcopy findings were normal and sent for histopathological examination. The finding of visual inspection of cervix with acetic acid and colposcopy were correlated with histopathological finding and compared with each other.Results: The age of participants ranged from 24 to 68 years with mean age of 38.17 years and mean parity of 2.25. visual inspection of cervix with acetic acid and colposcopy were positive in eight (20%) and ten (25%) respectively. There were five (12.5%) cases of histopathologically proven lesion. The sensitivity of visual inspection of cervix with acetic acid and colposcopy were 80% and 100 % respectively and that of specificity were 88.5% and 85.5%.Conclusions: visual inspection of cervix with acetic acid is an effective screening tool with comparable sensitivity and specificity. It can be used as alternative screening methods especially in low income resource countries where the burden of disease is high.Keywords: Cervical cancer; Colposcopy; screening; VIA.

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 Comparison of diagnostic value of visual inspection with Lugol’s iodine to conventional Paps smear in detection of colposcopic biopsy proved CIN: a tertiary care experience

2017 ◽  
Vol 6 (12) ◽  
pp. 5477
Author(s):  
Manisha Bajaj ◽  
Shamshad Ahmad ◽  
Shubha S. Trivedi
Keyword(s):  
Cervical Cancer ◽  
Sensitivity And Specificity ◽  
Visual Inspection ◽  
Pap Smear ◽  
Tertiary Care ◽  
Control Programme ◽  
Reproductive Age ◽  
Screening Methods ◽  
Tertiary Care Centre ◽  
Lugol’S Iodine

Background: An organized cytological screening (Pap smear) is the mainstay for cervical cancer prevention and control programme. Financial and logistic burden of operating such a program is considerable. This has prompted the evaluation of alternative feasible techniques. It appeared from the earlier studies that visual inspection with lugol’s iodine (VILI) could be a potential alternative to cervical cytology. VILI is a low cost, easy to apply and highly sensitive technique. It gives result immediately thus allows doctors to “see and treat” at first visit. Objective of present study was to evaluate the performance of visual inspection with lugol’s iodine and its comparison with cytology in cervical cancer screening.  Methods: 400 non-pregnant reproductive age women were subjected to Paps and VILI in this prospective study done in a tertiary-care centre in Delhi. Reference standard used for all was colposcopy and colposcopic-directed biopsy (when required).Results: Of 400 Pap smears done 11.75% were normal, 77.5% inflammatory, 5.5% had ASCUS, 0.25% ASC-H, 0.5% AGUS, 2% LSIL, 1.5% HSIL and invasive cancer in 0.5%. With LSIL and above smears as significant, the sensitivity and specificity of Paps were 50% and 97.66% respectively. VILI was positive in 12.8% of cases. Sensitivity and specificity of VILI was 85.5% and 89.9% respectively. Overall accuracy of VILI in detecting pre-invasive lesion was 89.7% while with pap smear it was 96%.Conclusions: Accuracy of VILI and Pap smear in detecting pre-invasive cervical lesion was comparable. At tertiary-care centers VILI can be used effectively to screen the patients with significant lesions. Patients can be directly subjected to further treatment at the earliest thus reducing loss to follow-up.

scholarly journals Review of Cervical Cancer Preventive and Screening Strategies in India

2019 ◽  
Vol 7 (6) ◽  
pp. 76-79
Author(s):  
Devi Meena ◽  
Subhash Chand ◽  
Deovrat Kumar
Keyword(s):  
Cervical Cancer ◽  
Risk Factor ◽  
Human Papillomavirus ◽  
Visual Inspection ◽  
Pap Smear ◽  
Screening Methods ◽  
Human Beings ◽  
Inspection Method ◽  
Pap Smear Test ◽  
Smear Test

Cervical cancer (CC) rapidly spread in the women. CC is the cancer which start from the cervix this is the 1st stage and 3rd most common type cancer in women’s worldwide. Continuously, Human papillomavirus (HPV) infection is the higher&strongest epidemiologic risk factor for CC.HPV-16 and HPV-18, these are type virus with high-risk HPV types. But at present many types of techniques available as – Pap smear test, Colposcopy, HPV virus test/detection, Visual inspection of cervix with 5% acetic acid, and Visual inspection of cervix with Lugol’s Iodine.The majority of diagnosis with CC will be analyzed more than 13000 and rate of death 4000 with women in United States and it also deadline disease in India. It is one of the cancer which is preventable. This article studied with in PubMed and Google scholar, studies about cervical cancer from Wikipedia and you-tube also. And it is only meta-analysis or multi-institutional, review article and research studies were considered for analysis of cervical cancer. The most important risk factor is determined with human beings Human papillomavirus (HPV) which traditional in worldwide. This is the type of cancer which is screening and detect in the early stage by the screening methods. In this article, abstracted published studies about to year between during 1995-2018 which has been carried out in worldwide on CC with significance on screening test methods.  Basically, Pap smear is the method of screening for cytology but now a day many studies have been accomplish to investigate different methods as well as visual inspection method. Keywords: Cervical Cancer screening, HPV, Screening methods, Pap Smear test, India United State.

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