scholarly journals Evaluation of Visual Inspection of Cervix with Acetic Acid and Liquid Based in Cervical Cancer Screening with Cervical Biopsy

2020 ◽  
Vol 18 (3) ◽  
pp. 426-430
Author(s):  
Bigya Shrestha ◽  
Karishma Malla Vaidya ◽  
Rijuta Joshi

Background: Cervical cancer is the second most common cancer among women in developing countries. Cervical cancer generally develops slowly over a period of 10-15 years. Incidence and mortality related to cervical cancer both have declining in developed countries because of effective screening programs through Papanicolaou smear. Therefore, cervical cancer can be prevented through implementation of different methods of screening programs like visual inspection of cervix with application of acetic acid visual inspection with acetic acid, liquid based cytology and human papilloma virus deoxyribonucleic acid. The purpose of this study is to compare the efficacy of  visual inspection with Acetic Acid with liquid based cytology in cervical cancer screening taking cervical biopsy as a gold standard. Methods: The study was conducted at Paropakar Maternity and Women’s Hospital, Kathmandu. One hundred forty four patients underwent visual inspection with acetic acid and liquid based cytology test followed by biopsy for confirmation of the lesion, when required. Data were obtained and statistically analyzed. Results: Out of 144 screened patients, 62 (43.05%) were positive in visual inspection with acetic acid test. Eighteen (12.5%) cases were positive in liquid based cytology. Thirteen women were positive with both tests. Thirty-nine cases underwent histopathological examination including 13 cases who were positive in both tests. The sensitivity, specificity, positive predictive value and negative predictive value for visual inspection with acetic acid was 81.25%, 65.22%, 61.90% and 83.33%, whereas for liquid based cytology it was 100%, 91.30%, 88.89% and 94.87% respectively. Conclusions: Liquid based cytology was more efficacious to diagnose atypical cells with higher sensitivity and specificity in comparison to that of  visual Inspection with Acetic Acid test. Keywords: Cervical cancer; liquid based cytology; visual inspection with acetic acid

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12009-e12009
Author(s):  
Surbhi Grover ◽  
Melody Ju ◽  
Lilie L. Lin ◽  
Shobha Krishnan

e12009 Background: Visual inspection with acetic acid and Lugol’s iodine (VIA/VILI) is increasingly reframed as a bridge modality through which low resource countries can provide cervical cancer screening while waiting for the more effective HPV DNA tests to become affordable. Often the screening programs are organized by government bodies that lack the trust of the local communities and hence such programs suffer from poor participation. Here we aim to describe a locally-sustained VIA/VILI screening program in rural Kutch district in India directed by Kutch Mahlia Vikas Sangathan (KMVS), a local NGO committed to women empowerment. Methods: All capacity-building measures (funding, training, materials, and healthcare workers) were rooted in the local community. Heath workers were sent to Tata Memorial Cancer Center in Mumbai for training. NGO members held information sessions prior the screening camps educating women about the significance of screening. A three-visit screening model using VIA/VILI was implemented. At first visit, all women were consented and screened. VIA/VILI positive women returned for a second visit for biospy. Biopsy positive women then returned for a third visit to arrange for treatment. All the screening camps were conducted in community buildings such as schools with the collaboration of the village leaders. Results: Screening camps were set up in 17 villages in 2010-2011, screening a total of 832 married women upto the age of 50. There were 0 cervical intraepithelial neoplasia (CIN) positive lesions or invasive cancers found. None of the women were lost to follow-up. Conclusions: It is feasible to develop a community level screening program and to provide cancer prevention needs from within a community. Future directions include further evaluation of downstream protocols after VIA/VILI tests, increasing health worker diagnostic and treatment capacity, and determining positive recruitment factors in women attending screening camps. The KMVS screening program has been well-received and has been approached by several other NGO’s and training centers seeking to build similar community-based cervical cancer screening programs.


Author(s):  
Maria R. Young ◽  
Julia M. Kramer ◽  
Jeffrey B. Chu ◽  
Jeffrey V. Hong ◽  
Kathleen H. Sienko ◽  
...  

Each year, cervical cancer causes the death of over 275,000 women worldwide with eighty percent of these cases occurring in low or lower-middle income countries. Cervical cancer screening programs reduce cervical cancer occurrence by identifying and treating pre-cancerous cervical abnormalities before they develop to malignant stages. Standard methods of screening are inappropriate for use in low-resource settings and therefore screening is very limited.  Based on a design ethnography studyperformed over a two-month period in Ghana, a need was identified for a low-fidelity model to assist in training healthcare providers to screen for cervical cancer using visual inspection with acetic acid. The design presented in this paper is a box trainer with a simulated vaginal cavity that allows a user to insert cervical images displayed on plastic tabs or cards from the Jhpiego Visual Inspection of the Cervix Flash Card Set©. A modular electronic feedback mechanism trains the user to properly complete the steps of the screening procedure and to track the successes of their diagnoses. This paper describes the need for a cervical cancer screening trainer, the process used to design a trainer to support visual inspection with acetic acid, and the results of prototyping and preliminary usability tests.


2020 ◽  
Vol 4 (3) ◽  
pp. 189
Author(s):  
Abu Sadat Mohammad Nurunnabi ◽  
Tahmina Sultana

Background: National screening programme for cervical cancer has been running in Bangladesh since 2004 through visual inspection using acetic acid (VIA). However, Pap’s smear is also used for the same, where it is available.Objectives: To see the effectiveness of VIA and Pap’s Smear as cervical cancer screening methods.Methods: This prospective study was done on 600 women who attended the outpatient gynaecology clinic and cervical cancer screening programme underwent both VIA and Pap’s smear cytology. Histopathology was taken as gold standard to compare the performance of VIA and cytology (Pap’s smear). Hence, positive cases were further subjected to colposcopy directed biopsy. Then the sensitivity and specificity of VIA and Pap’s smear were compared. The study was done in Dhaka Medical College Hospital, Dhaka, between July and December 2012.Results: On VIA, 46 had aceto-white lesions and on Pap’s smear, 28 had atypical squamous cells of undetermined significance (ASCUS) or worse lesions out of 600 women screened. 22 were positive on both VIA and cytology; 24 were positive on VIA only; and 6 were positive on cytology only. Histological diagnosis of CIN/carcinoma cervix was found in 36 positive cases, who underwent biopsy (n=52). Among them, 20 were picked up from Pap’s smear positive cases, whereas, 34 were VIA positive cases. VIA was found more sensitive (94.44%) than Pap’s smear (55.55%), which was statistically significant (p<0.001). However, the specificity of VIA was slightly lower (97.87%) than that of cytology (98.58%). Positive predictive value (PPV) of VIA was 73.91% for VIA and 71.42% for Pap’s smear, while Negative Predictive Value (NPV) were 9.63% and 97.2% respectively.Conclusion: VIA has got much more sensitivity and slightly lower specificity than that of Pap’s smear in cervical cancer screening.International Journal of Human and Health Sciences Vol. 04 No. 03 July’20 Page : 189-193


2017 ◽  
pp. 7-14
Author(s):  
Chidi Okorie Onwuka ◽  
Ima-Obong A. Ekanem

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.


2014 ◽  
Vol 136 (6) ◽  
pp. E743-E750 ◽  
Author(s):  
Pierre-Marie Tebeu ◽  
Joël Fokom-Domgue ◽  
Victoria Crofts ◽  
Emmanuel Flahaut ◽  
Rosa Catarino ◽  
...  

PLoS ONE ◽  
2016 ◽  
Vol 11 (6) ◽  
pp. e0157217 ◽  
Author(s):  
Elkanah Omenge Orang’o ◽  
Juddy Wachira ◽  
Fredrick Chite Asirwa ◽  
Naftali Busakhala ◽  
Violet Naanyu ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document