Visual inspection with acetic acid for detection of high grade lesion in atypical squamous cells and low grade squamous intraepithelial lesions from cervical Pap smear

Pothisuwan, Methasinee; Pataradool, Kamol; Tangjitgamol, Siriwan; Srijaipracharoen, Sunamchok; Manusirivithaya, Sumonmal; Thawaramorn, Thaowalai

doi:10.3802/jgo.2011.22.3.145

Cited by 16 publications

(11 citation statements)

References 31 publications

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“…Earlier studies have evaluated pap smear cytology, VIA with magnification (VIAM), visual inspection with Lugol's iodine (VILI) and HPV detection as the “triaging” tests for VIA. Studies evaluating Pap smear cytology or VIAM to triage VIA positive women did not observe significant benefits . Studies conducted in Zimbabwe and in India observed significant improvement in predictive value without any loss of sensitivity when HPV test was used to triage the VIA positive women .…”

Section: Discussionmentioning

confidence: 95%

“…Studies evaluating Pap smear cytology or VIAM to triage VIA positive women did not observe significant benefits. 29,30 Studies conducted in Zimbabwe and in India observed significant improvement in predictive value without any loss of sensitivity when HPV test was used to triage the VIA positive women. 31.32 However, both the studies were hospital based and among small number of subjects.…”

Section: Accuracy Of Via and Hc II Tests Used Sequentiallymentioning

confidence: 99%

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Diagnostic accuracy of VIA and HPV detection as primary and sequential screening tests in a cervical cancer screening demonstration project in India

et al. 2015

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Visual inspection after acetic acid application (VIA) and human papillomavirus (HPV) detection tests have been recommended to screen women for cervical cancer in low and middle income countries. A demonstration project in rural India screened 39,740 women with both the tests to compare their accuracies in real population setting. The project also evaluated the model of screening women in the existing primary health care facilities, evaluating the screen positive women with colposcopy (and biopsy) in the same setup and recalling the women diagnosed to have disease for treatment at tertiary center. Accuracy of VIA and HPV test used sequentially was also studied. VIA was performed by trained health workers and Hybrid Capture II (HC II) assay was used for oncogenic HPV detection. Test positivity was 7.1% for VIA and 4.7% for HC II. Detection rate of CIN 31 disease was significantly higher with HC II than VIA. Sensitivities of VIA and HC II to detect 162 histology proved CIN 31 lesions were 67.9 and 91.2%, respectively after adjusting for verification bias. Specificity for the same disease outcome and verification bias correction was 93.2% for VIA and 96.9% for HC II. Triaging of VIA positive women with HPV test would have considerably improved the positive predictive value (4.0 to 37.5% to detect CIN 31) without significant drop in sensitivity. All VIA positive women and 74.0% of HC II positive women had colposcopy. There was high compliance to treatment and significant stage-shift of the screen-detected cancers towards more early stage.A number of cross-sectional and randomized controlled studies have evaluated the test characteristics of Visual inspection with acetic acid (VIA) as well as that of human papillomavirus (HPV) detection for cervical cancer screening in low and medium income countries.1-4 These studies have convincingly established the utility of these tests and their superiority over conventional Pap smear cytology. The evidence regarding their cost-effectiveness is encouraging and the international organizations have also recommended their use in screening programmes. 5,6 Still the adoption of the new technologies for cervical cancer screening is low in the low or middle income countries (LMIC). Most of these countries continue with the opportunistic, low intensity and ineffectual cytology based screening, even though it is feasible for many of them to implement population based cervical cancer screening using either VIA or HPV detection tests. 7,8 The LMICs are quite diverse in terms of their health system capacities even within the countries. They can follow a "cafeteria approach" and choose from different screening tests and various diagnostic and treatment algorithms (single or multiple visit approaches) depending on the available resources and feasibility. Demonstration projects validating the research observations in real population settings and in convergence with the existing health infrastructure have catalyzed the initiation of VIA based cervical cancer screening programmes in some of the L...

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Section: Discussionmentioning

confidence: 95%

Section: Accuracy Of Via and Hc II Tests Used Sequentiallymentioning

confidence: 99%

Diagnostic accuracy of VIA and HPV detection as primary and sequential screening tests in a cervical cancer screening demonstration project in India

et al. 2015

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“…23,24 Pothisuwan M et al emphasized the significance of VIA that it may reduce the necessity of colposcopy which was in concordance with our study. 25 Ghosh P found, all biopsy positive cases (CIN I or worse) were VILI positive. 3 In Colposcopy, sensitivity was 83%, specificity 86%, PPV 51.3%, NPV 96.6%.…”

Section: Discussionmentioning

confidence: 99%

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

Paswan¹,

Kumar²,

Jha³

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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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.

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“…Overall, the incidence of cervical intraepithelial neoplasia (CIN) 2-3/adenocarcinoma in situ (AIS) ranged from 8.0% to 18.5% (Kiatpongsan et al, 2006;Kantathavorn et al, 2008;Suntornlimsiri, 2010;Poomtavorn et al, 2011;Pothisuwan et al, 2011;Ekalaksananan et al, 2011;Kingnate et al, 2014;). These findings were in line with previous studies from North America (Levi et al, 2003;Boardman et al, 2006;Selvaggi, 2006;Sherman et al, 2006;Srodon et al, 2006;Feng and Husain, 2007;Safaeian et al, 2007Siddiqui et al, 2008.…”

Section: Atypical Squamous Cells Of Undetermined Significancementioning

confidence: 99%

“…In a region with a low incidence of cervical cancer, positive smear results for LSIL were associated with CIN2-3/AIS in approximately 12%-18% of women on initial colposcopy and with less than 1% of underlying invasive cancer (Massad et al, 2001;ALTS Group, 2003;Fairman et al, 2004;Chute et al, 2006). In Thailand, reported incidence of significant cervical pathology ranges from 11.2% to 32.2% (Table 2) (Khuakoonratt et al, 2008;Boonlikit, 2008;Kiatiyosnusorn et al, 2010;Ekalaksananan et al, 2011;Pothisuwan et al, 2011;Kingnate et al, 2014). The significant finding noted in some studies in Thailand is a relatively high incidence of underlying high-grade cervical lesion (11.2%-30.3%) and invasive lesion (1.3%-1.9%) (Khuakoonratt et al, 2008;Kiatiyosnusorn et al, 2010).…”

Section: Low-grade Squamous Intraepithelial Lesionmentioning

confidence: 99%

Histopathological Outcomes of Women with Abnormal Cervical Cytology: a Review of Literature in Thailand

Kietpeerakool¹,

Tangjitgamol²,

Srisomboon³

2014

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 15 (16), 6489-6494 IntroductionCervical cancer remains the major health problem in Thailand and many other developing countries. This is mainly because of failure to initiate or sustain effective screening strategy. In recent population-based cancer registries, the highest incidence of cervical cancer in Thailand was noted in Chiang Mai with an average agestandardized incidence rate (ASR) of 28.9 per 100000, followed by Lampang (ASR, 22.4) and Bangkok (ASR, 20.9) (Moore et al., 2010).Although high-risk Human Papillomavirus (HR-HPV) test and HPV genotyping have certain role in cervical cancer screening nowadays, these tests are not widely available in developing countries. Cervical cytology is still the principal screening method. Subsequent management of abnormal cervical cytology to detect underlying cervical lesions is also important. Generally, management of abnormal cervical cytology depends on the risk of encountering high-grade cervical disease. However, the risks of high-grade cervical disease encountered in abnormal cervical cytology may vary among different regions of the world and across the country. Therefore, information regarding the incidence of significant cervical disease from different areas or populations is crucial for designing and implementing area-specific management approach. This review was conducted to evaluate the incidence of high-grade cervical diseases among Thai AbstractCervical cytology remains the principal screening method to detect pre-invasive and invasive cervical lesions. Management of abnormal cervical cytology depends on the risk of encountering a significant cervical lesion or high-grade cervical disease. These risks may vary in different areas across the country. Thus, determining the rate of significant cervical lesion associated with each type of abnormal cervical cytology in each area is of critical importance for designing area-specific management approach. This review was conducted to evaluate the rate of high-grade cervical disease among Thai women with abnormal cervical cytology. A relatively high incidence of underlying significant lesions including invasive disease was demonstrated even in those having only minimal smear abnormality. This baseline information is crucial and must be taken into consideration in management of women with abnormal cytological screening to achieve the goals of comprehensive cervical cancer control in Thailand.

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Visual inspection with acetic acid for detection of high grade lesion in atypical squamous cells and low grade squamous intraepithelial lesions from cervical Pap smear

Cited by 16 publications

References 31 publications

Diagnostic accuracy of VIA and HPV detection as primary and sequential screening tests in a cervical cancer screening demonstration project in India

Diagnostic accuracy of VIA and HPV detection as primary and sequential screening tests in a cervical cancer screening demonstration project in India

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

Histopathological Outcomes of Women with Abnormal Cervical Cytology: a Review of Literature in Thailand

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