IP Archives of Cytology and Histopathology Research


Evaluation of Effectiveness of Visual Inspection with Acetic Acid (VIA) Method for Screening of Cervical Lesions


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Author Details: Karumanchi Pushpalatha, Souujanya Rakam, Sreedevi Chowkula

Volume : 1

Issue : 3

Online ISSN : 2456-9267

Print ISSN : 2581-5725

Article First Page : 104

Article End Page : 107


Abstract

Introduction: Cervical cancer is the most common cancer among women in developing countries. Cervical cytology often referred to as Pap smear is a proven and reliable screening method. It requires large number of steps and is difficult to implement in low resource setting.  Visual inspection with acetic acid application is an alternative method which is cost effective, simple and can be easily implemented in under-resourced areas. At the same time its sensitivity and specificity are more or less same as that of Pap smears.
Aims and Objectives: To compare visual acetic acid test (VIA) with Pap smear test for screening of cervical lesions in unhealthy cervices.
Materials and Methods: This was a prospective hospital based study carried out over a period of six months from March to August 2016 in the departments of Pathology and Obstetrics and Gynecology, Maheshwara Medical College, Hyderabad. The study group consisted of 523 women, having unhealthy cervix on direct inspection. Pap smears were collected and then VIA test was performed on all subjects. The positive VIA tests were compared with the Pap smear reports.
Observations and Results: Women less than 40 years comprised 63 % cases.
Among pap smears, LSIL was more common and reported in 15 cases (55.56 %).
Out of total 523 cases, 19 cases (3.63 %) showed the SIL /squamous intraepithelial lesions. The positive cytology was seen in 21 cases (4.01 %) including both dysplastic and malignant conditions.
VIA test was positive in 27 cases (5.16 %) and showed 100 % sensitivity and 98.80 % specificity for detecting cervical lesions.
Conclusions: VIA test has high sensitivity and low specificity for picking up cervical lesions. The false positive cases can be reduced by Pap smear test or colposcopy guided biopsies. It is simple, easy to perform and gives immediate results thereby obviating the patients’ second visit for report collection. VIA is a real time screening test and a suitable alternative to Pap smear testing and is especially useful in low resource setting.

Keywords:
Cervical screening programs, Comparison of VIA and Pap smears, Pap smears, Unhealthy cervix, VIA test