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 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.

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 Comparison Between Pap Smear and Via As Screening For Cervical Lesions

2013 ◽  
Vol 1 (03) ◽  
pp. 55-60
Author(s):  
V. Harshini ◽  
Amritha Bhandary ◽  
Suchithra Thunga
Keyword(s):  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Screening Tests ◽  
Cervical Lesions ◽  
Low Resource Settings ◽  
Screening Programs ◽  
Low Resource ◽  
The Subject ◽  
Systemic Examination

Introduction: An important reason for higher cervical cancer incidence in developing countries is lack of effective screening programs like pap smear, aimed at detecting precancerous conditions before they progress to invasive cancer. The potential difficulties in implementing cervical cytology based screening in low-resource settings have prompted the investigation of accuracy of alternative low technology tests such as Visual inspection with acetic acid application [VIA], Visual inspection with acetic acid application with magnification [VIAM], visual inspection on Lugol’s Iodine application [VILI] in early detection of cervical neoplasia .In our study we compared pap smear with VIA to study the accurarcy of VIA as it is simpler and easier technique to be used as screening in low resource settings. Aim: This is a hospital based descriptive, prospective study to evaluate validity of pap smear and VIA techniques as screening tests in identifying cervical lesions. Materials And Methods: After general and systemic examination as a routine,visual local pelvic examination including visualisation of cervix and vagina per speculum and the findings are documented in the proforma .Then VIA and pap smear are done in that order, if any of these tests are positive then cervical biopsy will be taken and further advise to the subject is given. Results: A total of 313 women were involved in the study. The sensitivity of pap smear is 54.5% specificity is 98.9% while that of VIA 95.4% and 97.9%respectively. We found that VIA accuracy was comparatively more than that of pap smear. Conclusion: In low resource settings, usefulness of VIA is more than that of pap smear. We suggest to perform VIA in all the women inspite of having pap smear facility to improve detection rate of cervical lesions and provide better patient councelling and treatment.

scholarly journals Comparison of Diagnostic Efficacy of Visual Inspection of Cervix with Acetic Acid and Pap Smear for Prevention of Cervical Cancer: Is VIA Superseding Pap Smear?

2011 ◽  
Vol 3 (3) ◽  
pp. 131-134 ◽  
Author(s):  
Kamal Patil ◽  
G Durdi ◽  
KS Lakshmi
Keyword(s):  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Diagnostic Efficacy ◽  
Cross Sectional

ABSTRACT Objectives To estimate diagnostic efficacy of visual inspection with acetic acid (VIA) in comparison to Pap smear. Methods This cross-sectional study was carried over a period of 24 months on 200 women attending colposcopy clinic at KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum, India. All women enrolled in study underwent Pap smear, VIA, colposcopy and biopsy. The sensitivity, specificity, PPV, NPV, false-positive rate and false-negative rate were calculated for VIA, Pap smear and colposcopy with biopsy as the reference standard. Results In our study, sensitivity and specificity of VIA were found to be 86.95% and 72.51% respectively, and that of Pap smear 37.68% and 92.36% respectively. Colposcopy showed higher sensitivity (94.20%) and specificity (94.65%). Conclusion VIA is a suitable primary screening procedure alternative to Pap smear as it has high sensitivity and negative predictive value.

Managing cervical cancer in Nepal: Need of consensual guideline

1970 ◽  
Vol 4 (1) ◽  
pp. 3-10
Author(s):  
Gehanath Baral
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Intraepithelial Neoplasia ◽  
Nominal Data ◽  
Intervention Level ◽  
Feasible Alternative ◽  
Early Cervical Cancer ◽  
June July

The purpose of this review is to bridge the pattern of intervention in optimal and sub-optimal facility level.Several guidelines for the screening and treatment of cervical cancer are reviewed. Routine screening isfound grossly lacking and non existent outside major health institution. Only nominal data and interventionefforts found published. There are three prongs of intervention level namely prevention/screening, treatmentand palliation together. Pap smear test is the standard screening tool wherever the cyto-diagnostic facilityexists. Visual Inspection with Acetic acid and Lugol's Iodine will be the feasible alternative at low resourcesetting. Primary surgical treatment for early cervical cancer is the best option. Likewise chemo-radiation withor without surgery will be the alternative option. Need of at least an operational guideline in each institutionis realized at this moment as a recommendation.Key words: Cervical intraepithelial neoplasia (CIN); colposcopy; Pap smear (Papanicolou stain); radicalhysterectomy; visual inspection with acetic acid (VIA).DOI: 10.3126/njog.v4i1.3324Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 3-10

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 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.

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