Adequacy of visual inspection with acetic acid in women of advancing age

Abstract

Adequacy of VIA declined with age. However, the squamocolumnar junction was visible to the naked eye in the majority of women, indicating that they are good candidates for VIA.

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

“…However, another previous study showed no difference in the sensitivity and specificity of VIA testing performed in older women as compared with those performed in younger women (Sankaranarayanan et al, 2004;Sankaranarayanan et al, 2005;Dasgupta and Bhattacharya, 2012). In the elderly, regression of the transformation zone into the endocervix may diminish the adequacy and the sensitivity of VIA testing in detecting cervical dysplasia (Rochelson and Krumholz, 1983;Cremer et al, 2011). A previous study showed that the specificity of VIA testing was higher in post-menopausal women which is in agreement with our study (Denny et al, 2002).…”

“…One of the important determinants for positive VIA testing is clinical symptoms of patients (symptomatic or asymptomatic). Cervical infection or inflammation, and area of transformation zone which is affected by age, menopausal status, parity and route of delivery have been shown to affect the result of VIA testing (Vedantham et al, 2010;Cremer et al, 2011;Castle et al, 2014).…”

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

“…The accuracy of VIA/VILI depends on the ability to visualize the cervical transformation zone, the area where the original columnar epithelium covering the ectocervix has been replaced by squamous epithelium, and the area where oncogenesis begins. As women approach menopause and afterwards, the transformation zone recedes into the cervical canal and may no longer be visible, reducing accuracy of VIA (Cremer 2011). However, in younger women and women in whom the transformation zone is visible, the high negative predictive value of VIA (see below) suggests that significant lesions can generally reliably be excluded if VIA is negative.…”

A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya

“…20,21 However, it is also possible that the sensitivity of unaided visual screening is lower in older women because with age the transformation zone becomes less clearly visible during speculum examination -a recognized drawback of screening methods based on visual inspection. 22 This situation needs to be further explored in a study in which all participants undergo colposcopy with biopsy, regardless of screening results, especially in light of the findings of another study among HIV-infected women in Kenya that showed an increase in CIN 2+ with age. 23 Our results also show higher rates of positive VIA results among women using certain types of hormonal contraceptives and those who had known of their positivity to HIV for a longer time.…”