Visual inspection with acetic acid for cervical cancer screening in a tertiary health care centre

Agarwal, Shaily; Gupta, Renu; Agarwal, Apurva; Pandey, Kiran; Gupta, Nalini; Katiyar, Arti

doi:10.18203/2320-1770.ijrcog20160578

Cited by 4 publications

(5 citation statements)

References 8 publications

(9 reference statements)

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“…1 Similarly, in our study, we found 90 (86.5%) participants were multiparous followed by 11 (10.6%) grand multipara. This is similar to study conducted by Agarwal et al 9 The prevalence of positive VIA and cervical cytology was more among multiparous. It has been reported that metaplastic changes are also influenced by the trauma and repair experienced during delivery, and increased risk of cervical carcinoma has been identified in participants who are highly parous.…”

Section: Resultssupporting

confidence: 91%

Effectiveness of Visual Inspection with Acetic Acid and Cervical Cytology in Early Detection of Precursors of Cervical Cancer in Nepal

Singh

Shakya

Mudbari

2021

Kathmandu Univ. Med. J.

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Background Cervical cancer ranks as the first, most frequent cancer amongst Nepalese women. This can be prevented through primary prevention and early detection using screening techniques. Though cervical cytology is a standard screening tool in most of the developed countries, it fails to be the screening method of choice in low and middle income countries (LMICs) with limited resources due to financial and technical constraints. Objective This study aims at early detection of pre-cancerous lesion in cervix with cervical cytology and visual inspection with acetic acid. Method This is a hospital based, descriptive cross-sectional study. It included 104 women attending Obstetrics and Gynecology out-patient department (OPD) in Dhulikhel Hospital. Visual inspection of cervix with acetic acid (VIA) and liquid based cytology (LBC) was performed followed by cervical biopsy for positive VIA, or having abnormal cytology, or having unhealthy appearance of cervix even after treatment. Result The incidence of positive VIA and cytology screening was 38.5% and 7.7% respectively. The negative predictive value of VIA and cytology were similar whereas VIA was found to be more sensitive than cytology. Conclusion Cytology screening is used as an investigation of choice for screening of cervical cancer. In Nepal, VIA can be a good alternative for early detection of cervical cancer as it is found to be more sensitive than cytology.

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Section: Resultssupporting

confidence: 91%

Effectiveness of Visual Inspection with Acetic Acid and Cervical Cytology in Early Detection of Precursors of Cervical Cancer in Nepal

Singh

Shakya

Mudbari

2021

Kathmandu Univ. Med. J.

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“…According to the present study, the majority of the women were in the age group of 30 years and more with a mean age of 38.9 years. This result was in agreement with Agarwal et al,(2016) (12) study titled "Visual inspection with acetic acid for cervical cancer screening in a tertiary health care". They reported that their study sample had a mean age of 38.6 years.…”

Section: Discussionsupporting

confidence: 91%

“…In terms of parity, our result revealed that the majority of women were multigravida and multipara and one fifth of them had their age at first birth below 20 years. This is supported by the finding of Agarwal et al, (2016) (12) who found that 13.8% of the women were nulliparous, 45.6% had one or two live births, 28.6% had three or four, and 12.0% had five or more. The same finding is also in line with Desire et al, (2016) (18) who found that 86.0% of cases were multiparous.…”

Section: Discussionsupporting

confidence: 67%

Cervical Cancer Screening Using Acetic Acid Among High Risk Women and Plan of Nursing Action

Hussien¹,

Nour²,

Azaam³

et al. 2018

Mansoura Nursing Journal

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Background: Screening for cervical cancer using visual inspection with acetic acid (VIA) has been advocated by WHO as a suitable, low cost and feasible alternative modality for control of cervical cancer in low resource setting. The aim of the study was to assess cervical cancer screening for high risk women using acetic acid and implement the plan of nursing action. A cross-sectional design was carried out in the Gynecological OPD at Zagazig University Hospitals. A purposive sample of 100 females was required to estimate sensitivity and specificity of acetic acid in identifying pre malignant epithelial cell changes of the cervix. The tools used for data collection were; a structured interview sheet, clinical assessment sheet and the plan for nursing action. The results revealed that, women at risk for cervical cancer were more likely to be >30 years and more, their age of marriage was <20 years, had positive family history of cancer. They were also multipara, had repeated cervical laceration, exposed to STIs especially chlamydia and menorrhagia was present in 29.0% of them. Meanwhile post-coital bleeding was reported by 19.0% of the participants. Positive result for premalignant cervical lesion was 26.0% for VIA. Sensitivity and specificity of VIA were found to be 100% and 89.16% respectively. The accuracy of VIA was 91.0% which means that VIA test was more accurate. It can be concluded that VIA can effectively identify more cases of cervical intraepithelial neoplasia. It has been proven to achieve high sensitivity with an acceptable specificity. VIA test offers hope for universal screening as an alternate method for low resource setting. It is recommended that; VIA should be actively advocated to improve detection rate of cervical lesions so that it should be performed in all the women attending outpatient gynecological clinics.

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“…It can be performed by any healthcare worker with a low level of training making VIA a good alternative for low-resource settings. Some of the previous reports observed that it could reach similar or better results than the Pap smear in the detection of cervical intraepithelial neoplasia (CIN) 18 . VIA can be used as a primary screening test instead of cytology in developing countries where cervical cytological services are suboptimal as it has a sensitivity of 66% to 96% and specificity between 69% to 90% consistent with various studies 2,19 .…”

Section: Discussionmentioning

confidence: 99%

“…VIA can be used as a primary screening test instead of cytology in developing countries where cervical cytological services are suboptimal as it has a sensitivity of 66% to 96% and specificity between 69% to 90% consistent with various studies 2,19 . Studies have shown that VIA has a true positive rate comparable to Pap smear and also permits treatment and referral at the same visit by detecting pre-invasive cervical lesions in both low-resource and well-equipped health facilities 18,20 . It is shown by Consul et al in their study that VIA and VILI (visual inspection with Lugol's iodine) had sensitivity comparable to Pap smear and can thus be a suitable alternative/adjunctive test not only in a resource-poor setting but in well-equipped centres also 21 .…”

Section: Discussionmentioning

confidence: 99%

Direct Visual Inspection with Acetic Acid: A Cost-Effective Test for Cervical Cancer Screening

2021

PJMD

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Background: Cervical cancer is a major public health problem in developing countries due to ineffective screening programs. This study aimed to determine the accuracy of visual inspection with acetic acid (VIA) for cervical cancer screening in low-income population. Methods:This cross-sectional study was conducted in an outdoor clinic of Dow University Hospital from July 2016 to July 2017. A total of 108 women with vaginal discharge, post coital bleeding, inter menstrual bleeding and dyspareunia were enrolled in the study. A solution of 5% acetic acid was applied to the cervix and examined under adequate light for 1 min. VIA was reported as positive or negative according to acetowhite changes. Positive results were confirmed by biopsy. SPSS was used for statistical analysis. Sensitivity and specificity were calculated. Chi Squared test was applied and p-value ≤0.05 was considered statistically significant. Results:The average age of the patients was (mean± SD) 45.67±9.67 years. Out of forty-two patients who were VIA positive, n=38 had biopsy confirmed malignancy compared to seventeen women from the screened negative population (n=66) showing a sensitivity of 69.1% and specificity of 92.5%. We found 100% sensitivity and specificity in primipara. The positive predictive value (90.5%), negative predictive value (74.5%) and diagnostic accuracy of VIA positive were 80.6% respectively. Conclusion:VIA is a simple, cost effective and reliable screening test in low socioeconomic areas allowing instant diagnosis and treatment (p=0.0005). Thus, it decreases the chance of loss to follow-up and the number of visits to a healthcare provider.

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Visual inspection with acetic acid for cervical cancer screening in a tertiary health care centre

Cited by 4 publications

References 8 publications

Effectiveness of Visual Inspection with Acetic Acid and Cervical Cytology in Early Detection of Precursors of Cervical Cancer in Nepal

Effectiveness of Visual Inspection with Acetic Acid and Cervical Cytology in Early Detection of Precursors of Cervical Cancer in Nepal

Cervical Cancer Screening Using Acetic Acid Among High Risk Women and Plan of Nursing Action

Direct Visual Inspection with Acetic Acid: A Cost-Effective Test for Cervical Cancer Screening

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