Evaluation of Visual Inspection with Acetic Acid as a Feasible Screening Test for Cervical Neoplasia

Document Type : Original Article


1 Assistant Professor, Gynecology Oncology, Gynecologic Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Associate Professor of Biostatic, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Medical Student, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Cervical cancer is the second most common of cancer between women, it has long phase of preinvasive lesion. The aim of screening is diagnosis and treatment of precancerous lesion before produce of cancer. This study has been designed to assess if visual inspection with acetic acid 5% (VIA test) is a useful alternative for cytology as an accepted screening test for cervical cancer.
Methods: The study population included woman attending gynecological clinic in Ghaem Hospital in one year. After obtaining informed consent from each woman, pelvic examination and VIA was performed. One hundred woman with a positive VIA and one hundred with a negative VIA were randomly selected for this study. Cytology and colposcopy examination was performed for all 200 cases, and cervical biopsies were conduct for those individuals showing abnormal colposcopic findings. Those with CIN1 or worse lesions diagnosed by histology were considered true positive. Sensitivity, specifity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each tests and compare.
Results: 69 women in VIA positive group and 61 women in VIA negative group had abnormal cytology. From biopsy examination 58 woman in VIA positive and 2 women in VIA negative group had final diagnosis of displasia, while they were 43 and 17 for abnormal and normal cytology respectively. VIA test sensitivity and specifity were 96% and 70% respectively, while they were 72% and 38% for cytology test. There was a positive predictive value of 58% for VIA and a positive predictive value of 33% for cytology.
Conclusion: The result of this study indicates that VIA may be a useful and feasible alternative screening test for cervical precancerous and cancerous lesions.


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