scholarly journals Accuracy of visual inspection with acetic acid for cervical pathology screening in low cost setup

2020 ◽  
Vol 9 (4) ◽  
pp. 1335
Author(s):  
Aditya Sisodia
Keyword(s):  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Precancerous Lesions ◽  
Low Cost ◽  
Cancer Cervix ◽  
Accuracy Rate ◽  
Highly Sensitive ◽  
Set Up

Background: Cancer cervix, a preventable disease continues to be a cause of great concern to women’s health, being associated with agonizing morbidity and high mortality. Approximately 493,100 new cases and more than 273,000 deaths occur each year, among women worldwide.IN India the screening is largely based on pap smear, which is cumbersome procedure due to transportation of samples and follow up of patients are not usually feasible. Visual inspection with Acetic acid (VIA) is simple and easy to teach procedure. Follow-up of patients usually doesn’t require.Methods: This study includes a total of 1000 patients who attended OPD of gynecology. Each patient is subjected to VIA examination. Biopsy is taken from women with abnormal findings on VIA. The objectives of this study were to evaluate the sensitivity and specificity and positive predictive value of inspection of cervix with acetic acid in precancerous lesions of cervix.Results: When biopsy is taken as reference standard, VIA has sensitivity of 97.7%, specificity of 76.6%, PPV of 62.9% and NPV of 98.5%. The accuracy rate for VIA is 84.8%.Conclusions: VIA is highly sensitive for diagnosis and treatment of cervical pathology at the same sitting. It can be done cost effectively in low resource set up.

scholarly journals Visual inspection of cervix with acetic acid as a feasible screening test for cervical neoplasia among women attending at OPD in Rajshahi Medical College Hospital

KYAMC Journal ◽  
2018 ◽  
Vol 9 (2) ◽  
pp. 56-60
Author(s):  
Nahid Yusuf ◽  
Md Ahmed Ali ◽  
Nazmun Nahar ◽  
Shipra Chaudhury ◽  
Md Zillur Rahman
Keyword(s):  
Acetic Acid ◽  
Predictive Value ◽  
Urban Areas ◽  
Visual Inspection ◽  
Pap Smear ◽  
Low Cost ◽  
Low Grade ◽  
College Hospital ◽  
Health Care Centre ◽  
Simple Method

Background: Visual inspection of cervix after application of 3-5% acetic acid (VIA) is a potential alternative to Pap smear cytology for screening of cervical cancer in resource poor settings.Objectives: This study was to evaluate the performance of visual inspection based screening approach in the detection of precancerous and early cancerous lesions of the cervix.Materials & Methods: VIA was carried out in 540 eligible women attending Gynae OPD. Detection of well-defined, opaque, acetowhite lesion close to squamocolumnar junction or in transitional zone of the cervix constituted positive VIA. All screened women evaluated by colposcopy and biopsy were taken from colposcopically suspected areas. The final diagnosis was based on histology.Results: Out of 540 patients, 328 were VIA negative and 212 were VIA positive. Colposcopy showed normal results in 340 cases, low grade CIN in 138 cases, high grade CIN in 44 cases and cancer in 18 cases. There were biopsy proven chronic cervicitis and metaplastic changes in 423 cases, CIN I in 66 cases, CIN II in 25 cases, CIN III / carcinoma-in-situ in 5 cases. The sensitivity of VIA was 74.36%, specificity 70.45%, positive predictive value 41.04%, & negative predictive value 90.85%.Conclusion: VIA can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. As it is low cost and simple method, it can be set in any hospital or any health care centre of rural or urban areas of poor resource settings.KYAMC Journal Vol. 9, No.-2, July 2018, Page 56-60

scholarly journals Visual Inspection with Acetic Acid (VIA) in cervical cancer screening in low resource settings

2014 ◽  
Vol 13 (4) ◽  
pp. 454-459
Author(s):  
Shaheen Shaheen ◽  
Rajyashri Sharma ◽  
Rashi Rashi
Keyword(s):  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Screening Program ◽  
Low Cost ◽  
Medical Science ◽  
High Sensitivity ◽  
Intraepithelial Neoplasia ◽  
Screening Methods ◽  
Cervical Lesions

Objective: To evaluate the feasibility and validity of visual inspection of the cervix with acetic acid (VIA) for screening cervical intraepithelial neoplasia. Materials and Methods: In this study, 942 women recruited from gynecology outpatient clinic, were screened using the Papanicolaou (PAP) smear, and VIA. The sensitivity and specificity of both the screening methods were analyzed. Results: VIA was positive in 29.3%. The sensitivity of VIA (74.16%) was much higher than that of the Pap smear (47.83%). The specificity of VIA (50.00%) was lower than that of the Pap smear (74.16%), resulting in high false-positive rates for VIA. Conclusion: Visual inspection of the cervix with acetic acid is sensitive for ecto-cervical lesions. The advantage of the VIA method lies in its easy technique, low cost and high sensitivity which are important factors for determining the efficacy of any screening program in developing countries. DOI: http://dx.doi.org/10.3329/bjms.v13i4.15019 Bangladesh Journal of Medical Science Vol.13(4) 2014 p.454-459

scholarly journals Development of algorithms for automated detection of cervical pre-cancers with a low-cost, point-of-care, Pocket colposcope

2018 ◽  
Author(s):  
Mercy Nyamewaa Asiedu ◽  
Anish Simhal ◽  
Usamah Chaudhary ◽  
Jenna L. Mueller ◽  
Christopher T. Lam ◽  
...  
Keyword(s):  
Acetic Acid ◽  
Visual Inspection ◽  
Point Of Care ◽  
Low Cost ◽  
Intraepithelial Neoplasia ◽  
Support Vector ◽  
Machine Model ◽  
Data Set ◽  
Automatic Feature Extraction ◽  
Lugol’S Iodine

AbstractGoalIn this work, we propose methods for (1) automatic feature extraction and classification for acetic acid and Lugol’s iodine cervigrams and (2) methods for combining features/diagnosis of different contrasts in cervigrams for improved performance.MethodsWe developed algorithms to pre-process pathology-labeled cervigrams and to extract simple but powerful color and textural-based features. The features were used to train a support vector machine model to classify cervigrams based on corresponding pathology for visual inspection with acetic acid, visual inspection with Lugol’s iodine, and a combination of the two contrasts.ResultsThe proposed framework achieved a sensitivity, specificity, and accuracy of 81.3%, 78.6%, and 80.0%, respectively when used to distinguish cervical intraepithelial neoplasia (CIN+) relative to normal and benign tissues. This is superior to the average values achieved by three expert physicians on the same data set for discriminating normal/benign cases from CIN+ (77% sensitivity, 51% specificity, 63% accuracy).ConclusionThe results suggest that utilizing simple color- and textural-based features from visual inspection with acetic acid and visual inspection with Lugol’s iodine images may provide unbiased automation of cervigrams.SignificanceThis would enable automated, expert-level diagnosis of cervical pre-cancer at the point-of-care.

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 study of effectiveness of pap smear versus visual inspection with acetic acid for mass screening of lesions of cervix

2018 ◽  
Vol 6 (6) ◽  
pp. 2042
Author(s):  
Mercy Mrudula Dasari ◽  
Venkatalakshmi Anem ◽  
Sirisha Gunta ◽  
Satish Kumar Seeram ◽  
Bhagyalakshmi Atla
Keyword(s):  
Acetic Acid ◽  
Epithelial Cell ◽  
Screening Test ◽  
Visual Inspection ◽  
Pap Smear ◽  
Cervical Lesions ◽  
Papanicolaou Test ◽  
Promising Alternative ◽  
Screening Programs ◽  
Specificity And Sensitivity

Background: Cervical cancer is a leading cause of morbidity and mortality among women worldwide and more over in the developing countries, so there is a need to develop screening test with high specificity and sensitivity. Aim of the study was to evaluate the effectiveness of Papanicolaou (PAP) smear versus visual inspection acetic acid (VIA) for screening cervical lesions in patients and to determine and compare their sensitivity and specificity.Methods: The present study is a hospital based prospective study for a period of two years at the department of pathology from August 2014 to July 2016 consisting of 500 patients attending gynaecology outpatient clinic. Papanicolaou (Pap) smear tests and visual inspection acetic acid were employed along with complete clinical history record. The results of VIA were correlated with that of pap smear on the basis of sensitivity, specificity and positive and negative predictive value.Results: Out of 500 cases, most common age group was 21 to 40 years of age consisting of 305 cases - 61%. VIA was positive in 156 cases-31.2%, PAP smear positive for epithelial cell abnormalities were 60 cases-12%. VIA showed higher sensitivity (52.38%) compared to Pap smear (40%) whereas Pap smear showed higher specificity (93.2%) compared to VIA (92.4%).Conclusions: Papanicolaou test is a better screening test for epithelial cell abnormality than VIA. However, in countries with low resource settings where cytology-based screening programs are not available, VIA is a promising alternative.

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