Cervical cytology in healthy and unhealthy cervices with acetic acid as agent for visual inspection

Abstract

Introduction: Cervical cancer is the fourth most common cancer among women globally. Though very common, it is a potentially preventable. In developing countries, there is a lack of effective screening programs, like routine Papanicolaou (Pap) smear testing. Also implementation of such programs in low-resource settings is difficult. Aims : To determine the best suited screening modality in our hospital setting among Pap smear and VIA. Materials and Methods: This was a prospective hospital based study done over a period of three years. It included 200 women who underwent Pap smear test and (Visual inspection with acetic acid) VIA and 120 women who underwent cervical biopsy. Result: 120 women were subjected to cervical biopsy. The most common finding on per speculum examination was white discharge followed by erosion. Incidence of epithelial cell abnormalities was more among 4th and 5th decades of life. Incidence of CIN was more in women with parity 3 and above, Incidence of CIN was more in women married at a younger age i.e below 20 years of age. Sensitivity and specificity of Pap test was 80% and 93 % respectively and that of VIA was 93.3% and 80% which are statistically significant. PPV of Pap is 63.15% and VIA is 40% and NPV of Pap is 97.02% and VIA is98.8%.Conclusion: VIA is more sensitive than Pap smear but is less specific. The advantages of VIA are that it is simple, rapid, easy to perform, cost-effective, and its result is available immediately so that further investigations can be done in the same sitting. Thus, VIA is accurate screening test and suitable alternative to Pap smear.