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Screening for cervical carcinoma using visual inspection with acetic acid
E-S Abdel-Hady1, M Emam, A Al-Gohary
1Department of Obstetrics and Gynecology, Mansoura University, Egypt. elsaidhady@yahoo.co.uk
Summary
Visual inspection with acetic acid (VIA) effectively screens for cervical cancer in Egypt. While it yields some false positives, VIA demonstrates high sensitivity (97%) for detecting cervical intraepithelial neoplasia (CIN).
Area of Science:
- Gynecologic Oncology
- Public Health Screening Programs
- Diagnostic Test Performance Evaluation
Background:
- Cervical cancer remains a significant health concern, particularly in regions with limited access to advanced screening technologies.
- Early detection through effective screening is crucial for improving patient outcomes and reducing mortality rates associated with cervical carcinoma.
- Visual inspection with acetic acid (VIA) offers a low-cost, accessible method for cervical cancer screening.
Purpose of the Study:
- To evaluate the diagnostic performance of visual inspection with acetic acid (VIA) for the early detection of cervical carcinoma.
- To assess the utility of VIA as a primary screening tool in the Dakahlia Governorate, Egypt.
Main Methods:
- A screening study involving 5,000 women in Dakahlia Governorate, Egypt.
- Application of 5% diluted acetic acid to the cervix during routine gynecologic examinations.
- Referral of women with positive VIA results for colposcopy; those with negative results were referred based on clinical indications.
Main Results:
- Of 5,000 women screened, 409 were referred for colposcopy.
- Cervical intraepithelial neoplasia (CIN) was diagnosed in 151 (60%) of 253 women with positive VIA results and 4 of 156 with negative results.
- VIA demonstrated a sensitivity of 97% and a negative predictive value of 97%, with a positive predictive value of 60% for all CIN grades and 90% for high-grade CIN.
Conclusions:
- Visual inspection with acetic acid (VIA) is a valuable screening test for cervical carcinoma, exhibiting high sensitivity.
- Despite a relatively high rate of false-positive results, VIA's performance supports its use in resource-limited settings for early cervical cancer detection.
- The study highlights VIA's potential to improve cervical cancer screening coverage in the Dakahlia Governorate.
