In view of the failure of cytology screening programmes for cervical cancer in developing countries, the World Health Organization suggested unaided visual inspection of the cervix after an application of acetic acid (VIA) and Lugol's iodine (VILI) as alternative screening methods. Our study evaluates the effectiveness of VIA and VILI compared to Pap smear as screening methods for carcinoma of the cervix in a low-resource setting. Three hundred and twenty-eight women were subjected to a Pap smear test, VIA, VILI and colposcopy. The results were as follows: Pap smear test (20.83%, specificity 98.38%), VIA (55.5%, 71.39%) and VILI (86.84%, 48.93%). Although VIA and VILI are less specific in comparison to the Pap smear test, they are more sensitive in detecting pre-invasive lesions. Hence VIA and VILI can be used as cervical cancer screening tools in low-resource settings.
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