Visual inspection of cervix with acetic acid: A good alternative to pap smear for cervical cancer screening in resource limited setting

Abstract

Objective: Determine the diagnostic accuracy of visual inspection of cervix (VIA) by using 3% acetic acid as a screening test for early and timely detection of cervical cancer when histopathology taken as the gold standard of diagnosis. Study Design: Cross Sectional study. Place and Duration of Study: This study was conducted at the Department of Gynaecology and Obstetrics, Allied Hospital, Faisalabad from February 2016 to February 2017. Materials and Methods: All statistical data was entered and analyzed by using SPSS version 23. Frequencies and percentages were calculated and presented for qualitative variables like marital status. Parity, ethnic group and religion. Mean ± Standard Deviation (SD) was calculated for numerical variables like duration of marriage and age. The diagnostic accuracy, sensitivity specificity and positive predictive value (PPV) and negative predictive value (NPV) was calculated using two into two contingency table and histopathology was taken as the gold standard. Results: Overall, 100% (n=320) female patients were included, in this study. There were 87.2% (n=279) patients had poor socio-economic status, while 12.8% (n=41) had good socio-economic status. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of VIA and abnormal looking cervix were 81.7%, 80.7%, 51.5%, 48.5% and 81.3% respectively. Conclusion: Screening schedules are not planned and followed in Pakistan ever, so VIA is effective and always a useful diagnostic test for cervical cancer, pre-cancerous lesions can be detected at their early stage through VIA and mortality and morbidity can be reduced.