Visual inspection with acetic acid as a feasible screening test for cervical neoplasia in Iran

Abstract

The aim of this study was to estimate the sensitivity and specificity of visual inspection of the uterine cervix with acetic acid (VIA) as a screening test for cervical carcinoma and its precursors. One thousand and two hundred eligible women were screened by VIA and Papanicolaou smear. Those positive on one or both of these screening tests (n = 308) or those who had clinically suspicious lesions, even if the tests were negative [25% of remainders (n = 290)], were referred for colposcopy. Three hundred and fifty five of 598 women at colposcopy underwent biopsies or endocervical curettage. Those with cervical intraepithelial neoplasia I (CIN I) or worse lesions, diagnosed by histology, were considered true positive. VIA was positive in 191 women (16.1%). In 175 true-positive cases, VIA detected 130 cases, yielding a sensitivity of 74.3% and a specificity of 94%. By considering atypical squamous cell of undetermined significance or worse lesions on Papanicolaou smear as referring threshold for colposcopy, the sensitivity and specificity of cytology were 72 and 90.2%, respectively. In conclusion, the sensitivity and specificity of VIA is high and comparable with that of cytology. Hence, VIA can be undertaken as a feasible method of screening in cervical cancer in countries where access to cytopathology is limited.

Screening of Cervical Cancer by VIA among women in Rajshahi Medical College Hospital

“…But various studies proved that visual inspection of the uterine cervix after the application of 3-5% freshly prepared acetic acid can lead to the satisfactory detection of cervical lesions and lesions missed by cervical cytology. [15][16][17][18] Since we screened a hospital-based symptomatic population, our VIA positivity rate was higher than that found in other studies. If this test had done among general population, we may have obtained lower positive rates.…”

“…The sensitivity of VIA to detect mild dysplasia or worse, as shown in various studies, ranges from 63% to 77% [19][20][21][22][23] . In our study, the sensitivity of VIA was 74.36%.…”

Accuracy of visual inspection with acetic acid in cervical ectopy evaluation

“…It was also in agreement with Wesley et al (1997) who reported in their study about evaluation of visual inspection as a screening test for cervical cancer that VIA test was positive in half of their sample. [15] On the other hand, this result was in disagreement with the findings of Kavita et al (2010) [11] who reported positive VIA test in less than one fifth of their study subjects and also with the findings of Ghaemmaghami et al (2004) [16] who reported in their study about "visual inspection with acetic acid as a feasible screening test for cervical neoplasia" that VIA test was positive in only less than one fifth of their study sample.…”

Development of a visual inspection programme for cervical cancer prevention in Bangladesh

“…A number of studies have shown the advantages of VIA, including its low cost, simplicity of use, high sensitivity and instant results. [1][2][3][4] A study in Nigeria showed higher sensitivity of VIA (100%) than that of Pap smears (85.7%). The negative predictive value of VIA was 100%, while the positive predictive value was 20%.…”