VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

Abstract

Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.

Concurrent cytologic and colposcopic evaluation of symptomatic cervical erosion

“…This was comparable to studies by Goldacre et al, Paswan et al, Bhalerao et al and Garg et al where the most common presenting complaint was consistently vaginal discharge which may or may not be associated with lower backache. [6][7][8][9] In a study by Dasari et al unhealthy vaginal discharge was observed in 13.3% patients which was comparable to 25% patients presenting with unhealthy vaginal discharge in the present study. 10 This increased incidence of unhealthy vaginal discharge may be attributed to the increased prevalence of lower socioeconomic strata and poor personal hygiene in our study group.…”

“…It was comparable to the study by Sharma et al and Pankaj et al in which the most common age group was 31-40 years. The mean parity in the present study was 2.78±1.39 which was comparable to the studies by Sharma et al, Paswan et al and Bhalerao et al[4][5][6][7] The most common presenting complaint in this study was vaginal discharge as seen in 68.8% patients. This was comparable to studies by Goldacre et al, Paswan et al, Bhalerao et al and Garg et al where the most common presenting complaint was consistently vaginal discharge which may or may not be associated with lower backache [6][7][8][9].…”

“…The mean parity in the present study was 2.78±1.39 which was comparable to the studies by Sharma et al, Paswan et al and Bhalerao et al[4][5][6][7] The most common presenting complaint in this study was vaginal discharge as seen in 68.8% patients. This was comparable to studies by Goldacre et al, Paswan et al, Bhalerao et al and Garg et al where the most common presenting complaint was consistently vaginal discharge which may or may not be associated with lower backache [6][7][8][9]. In a study by Dasari et al unhealthy vaginal discharge was observed in 13.3% patients which was comparable to 25% patients presenting with unhealthy vaginal discharge in the present study 10.…”

“…Hence, colposcopy and histopathology are dependent on each other implying that a colposcopic report suggestive of some degree of malignancy has a clinically significant probability of the histopathology report confirming it. [4][5][6][7] The most common presenting complaint in this study was vaginal discharge as seen in 68.8% patients. This was comparable to studies by Goldacre et al, Paswan et al, Bhalerao et al and Garg et al where the most common presenting complaint was consistently vaginal discharge which may or may not be associated with lower backache.…”

Outcome and barriers to cervical cancer screening amongst human immunodeficiency virus-positive women attending Aminu Kano Teaching Hospital, Kano State, Nigeria

“…Visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) are increasingly recommended in various cervical cancer screening protocols in low-resource settings; although VIA is more widely used, VILI has been advocated as an easier and more specific screening test (Huchko et al, 2015). In many developing countries where pap smear and colposcopy are not available, both VIA and VILI remain very helpful tools in picking up abnormal-looking cervix which can then be confirmed by pap smear or colposcopy especially among individuals at high risk of cervical cancer such as WLHIV (Paswan et al, 2018). It's expected that screening using any of the two methods can go a long way in reducing the incidence of cervical carcinoma among HIV-positive women.…”