A comparison of four screening methods for cervical neoplasia in a developing country

Cronjé, H. S.; Parham, Groesbeck P.; Cooreman, Bruno; Beer, Amanda de; Divall, Peter; Bam, Roosmarie H.

doi:10.1067/mob.2003.153

Cited by 82 publications

(52 citation statements)

References 9 publications

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“…The sensitivity of VIA testing in detecting highgrade CIN and cervical cancer ranged from 67-79% and the specificity varied from 49-86% in previous crosssectional studies which used VIA testing as a primary screening test (Denny et al, 2002;Cronje et al, 2003;Sankaranarayanan et al, 2004;Sankaranarayanan et al, 2005). Our study demonstrated overall sensitivity and specificity of 59.4% and 76.2%, respectively of VIA testing in detecting high-grade CIN in women with minor cervical cytological abnormalities.…”

Section: Discussionmentioning

confidence: 48%

Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities

Poomtavorn¹,

Suwannarurk²

2015

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 48%

Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities

Poomtavorn¹,

Suwannarurk²

2015

Asian Pacific Journal of Cancer Prevention

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“…It was also in agreement with the findings of Cronje et al 2003 who reported in their study about comparison of four screening methods for cervical neoplasia in a developing country that the specificity of VIA was 48.5%. [19] However this result was in disagreement with the findings of Sankaranarayanan et al [8,20] who reported a much higher VIA specificity of 65% & 81.9%, respectively.…”

Section: Itemscontrasting

confidence: 57%

Accuracy of visual inspection with acetic acid in cervical ectopy evaluation

Sheesha

Mansour

Kheder

et al. 2015

JNEP

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Background: Cervical erosion is one of the most common pathological conditions encountered in outpatient gynecological clinics in middle-aged women. A simple method for diagnosis and treatment can play a tremendous role to comfort these women. Methods: The study includes fifty female patients attended the outpatient clinic of obstetrics & gynecology department in Mansoura University hospitals. All patients selected according to inclusion and exclusion criteria. The study was undertaken during the period from June 2014 to December 2014. Tools: Two tools were used for data collection: (1) Interviewing questionnaire schedule divided into three parts which were used to assess general characteristics of women, obstetric and gynecological history and the presence of cervical ectopy symptoms. (2) Local cervical assessment by vinegar acetic acid (VIA) test. Results: The study results revealed that 30 subjects (60%) were VIA positive and 20 subjects (40%) were VIA negative. VIA sensitivity was 100%, specificity 45%, PPV 71% and NPV 75%. There was a statistically significant relation between duration of marriage, high parity, IUDs use and VIA positivity. Conclusions: Using VIA test was an accurate and effective method for detection of cervical ectopy. VIA test should be performed in all the women attending outpatient gynecological clinics even in the presence of Pap smear facility to improve detection rate of cervical lesions and provide better patient counseling and treatment.

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“…Our findings were like that reported by Osmanabad district RCT. [11] While Cronjé et al 2003 [12] reported a higher prevalence of LSIL and above smears, Luthra et al [9] found lower prevalence (dysplasias 1.4% and carcinoma 0.15%). In contrary Ghosh et al, 2013, [13] reported abnormal Pap smear in 3.7% cases only while Saleh et al 2013, [14] in an Egyptian study, as 4%.…”

Section: Discussionmentioning

confidence: 99%

“…The estimated prevalence by Cronjé et al of CIN 2 was 4.6%, and CIN3 was 2.8 % while invasive lesion was found in 0.8%. [12] Our study has taken three thresholds for consideration of Pap smear as positive. First taking ASCUS and above as positive, second, LSIL and above as positive and third HSIL and above as positive.…”

Section: Discussionmentioning

confidence: 99%

Potential of visual inspection with acetic acid as a screening test in comparison to conventional papanicolaou smear in detection of colposcopic biopsy proven cervical intraepithelial neoplasia: A tertiary centre experience

Bajaj¹,

Ahmad²,

Trivedi³

2017

Int J Med Sci Public Health

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INTRODUCTIONAs per population-based cancer registries in India, cervical carcinoma is the second most common cancer among women after breast cancer.[1] Majority (83%) of the cases occur in developing countries which possess only 5% of global resources.[2] India is a high-risk country for cervical cancer, Background:Although it is well established that organized cytological screening programs are the mainstay for cancer cervix control but the financial and logistic burden of operating such a program is considerable. This has prompted the evaluation of alternative feasible techniques. Early and ongoing comparative studies worldwide showed visual inspection with acetic acid (VIA) as potential alternatives to cervical cytology because of their low cost, the ease of use, high sensitivity and immediate result allowing "see and treat" at first visit. Objectives: To evaluate the performance of VIA and its comparison with cytology in cervical cancer screening. Materials and Methods: A total of 400 non-pregnant reproductive age women were subjected to papanicolaou Pap smear) and VIA 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 atypical squamous cells (ASC) atypical glandular cells of undetermined significance (AGUS), 0.25% ASC-H, 0.5% AGUS, 2% low-grade squamous intraepithelial lesions (LSIL), 1.5% high-grade squamous intraepithelial lesion (HSIL), and invasive cancer in 0.5%. With LSIL and above smears as significant, the sensitivity and specificity of Pap were 50% and 97.66%, respectively. VIA was positive according to two thresholds. When high-threshold was used then only well demarcated, opaque white areas near the squamocolumnar junction were taken as positive whereas in low-threshold criterion faint or ill-defined ace to white anywhere and well-defined areas away from squamocolumnar junction was also taken as positive. 29.3% were positive with low-threshold criterion for VIA and 9.3% with high-threshold criterion. The sensitivity with low-threshold criteria was 100% and specificity 72.7%. Conclusion: The sensitivity with low-threshold criteria was 100% and specificity 72.7%. With high-threshold sensitivity and specificity were 85.7% and 95%, respectively. Conclusion: VIA with low-threshold criteria had high sensitivity (100%), but specificity (72.7%) was low, but with high-threshold criteria for positivity, the specificity increases up to 95% which is comparable to cytology. The gynecologists in tertiary-care centers can use the high-threshold criterion effectively, and patient with significant lesions can be directly subjected to further treatment at the earliest thus reducing loss to follow-up.

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A comparison of four screening methods for cervical neoplasia in a developing country

Cited by 82 publications

References 9 publications

Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities

Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities

Accuracy of visual inspection with acetic acid in cervical ectopy evaluation

Potential of visual inspection with acetic acid as a screening test in comparison to conventional papanicolaou smear in detection of colposcopic biopsy proven cervical intraepithelial neoplasia: A tertiary centre experience

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