Detection of cervical intraepithelial neoplasia (CIN) by visual inspection of cervix with acetic acid (VIA) and its comparison to cervical cytology

Abstract

Background: Cervical cancer is the second most common cancer in women throughout the world, and it is the leading cause of cancer death among women in underdeveloped countries like Bangladesh is preventable and curable if detected at and early stage using proper screening tools. This study was done to see the effectiveness of VIA and find out the CIN and introduce as a complementary to cytology for diagnosing precancerous form of cervix.
 Materials & Methods: A total 175 subjects were studied & relevant data of cervix related patients have been collected. The data regarding Pap smear, VIA and biopsy have been taken and collected data was analysis by SPSS.
 Results: Out of 175 Patients VIA positive 53 (30.3%), Pap smear reports, 84 (48.0%) had inflammatory findings and 38 (21.7%) had dysplasia and biopsy result 41(23.4%) CIN positive. Sensitivity of VlA was 90.2%, specificity 88.1%, PPV 69.8%, NPV 96.7% and accuracy 88.6%. Sensitivity of Pap smear reports was 80.5%, specificity 96.3%, PPV 86.8%, NPV 94.2% and accuracy 92.6%.
 Conclusion: Visual inspection of cervix after application of acetic acid (VIA) is valid as cytology test for the identification of pre-invasive cervical cancer (CIN). Thus VIA is a useful screening method of Cervical Intraepithelial Neoplasia lesion as Pap smear.
 TAJ 2018; 31(1): 15-20

Accuracy of Naked Eye Visual Inspection in Early Detection of Cervical Intraepithelial Neoplasia at Zagazig University Hospitals

“…In the current study, visual naked eye inspection with acetic acid staining was negative in 85 (41.3%), low threshold positive in 75 (36.4%), and high threshold positive occurred in 46 (22.3%). In agreement with our study, Zahan et al (12) demonstrated that out of all patients 53 (30.3%) had VIA positive and 122 (69.7%) had VIA negative findings. While in Belinson et al (14) study, they demonstrated that visual inspection was done on all 1997 women in the study.…”

“…High threshold positive VIA can predict malignant nature of lesion with 84.8% sensitivity, 80.8% specificity, 58.7% positive predictive value, 94.1% negative predictive value, and 81.7% accuracy. In agreement with our study, Zahan et al (12) demonstrated that among the validity test the sensitivity, specificity, PPV, NPV and accuracy of VIA report was 90.20%, 88.10%, 69.80%, 96.70%, 88.6% respectively.…”

“…In the current study, the main complaint was in 132 (64.1%) vaginal discharge, 25 (12.1%) dyspareunia and 6 (2.9%) postcoital bleeding. This comes in agreement with the study of, Zahan et al (12) who reported that patient who attended the outpatient clinic were with common complaints of vaginal discharge as foul smell, blood stain discharge, discharge with itching, post coital bleeding, and postmenopausal bleeding. All the women were married and were sexually active.…”

Comparative Study of Pap Smear Verses Visual Inspection with Acetic Acid in Screening for Cervical Cancer

“…In our study 35 .85 % of women were in the age group of 31 -40yrs , Our study was similar to the study done by Niyodusenga A et al 6 32.3% of women were in age group 41-50 yrs . By a study done by Zahan .N et al 7 25 .7 % women were in the age group of 26-30 years .…”