Evaluation of downstaging, visual inspection with acetic acid and lugol's iodine in screening of cervical cancer

Abstract

Objectives: To detect and compare the sensitivity and specificity of downstaging and visual inspection with acetic acid (VIA) and with Lugol's iodine (VILI). Methods: Screening with downstaging, VIA and VILI were done on 680 women who fulfilled the inclusion criteria at a primary health center attached to the university hospital, over a period of one year. Those who had abnormal results in downstaging, VIA and VILI were biopsied and sensitivity, specificity, negative predictive value and positive predictive value were calculated. Results: The sensitivities of downstaging, VIA and VILI were 54.55, 63.64 and 90.91% and specificities were 93.42, 95.07 and 97.46% respectively. The positive predictive value of downstaging, VIA and VILI were 12.01, 17.5 and 35.7% and negative predictive values were 99.2, 99.37 and 98.85% respectively. Conclusion: VIA and VILI are suitable primary screening procedures as compared to downstaging because of high sensitivity and specificity. The negative predictive value of downstaging, VIA and VILI is better than the positive predictive value. Downstaging can be used in rural areas where acetic acid and Lugol's iodine are not available.