Divya Hegde1, Harish Shetty, Prasanna K Shetty, Supriya Rai. 1. Department of Obstetrics and Gynaecology, A. J. Institute of Medical Sciences, Deralakatte, Mangalore, Karnataka, India. divyahegde31@yahoo.co.in
Abstract
AIM: To assess the role of visual inspection with acetic acid as an alternative to Pap smear and in screening program for cervical cancer in low resource settings. MATERIALS AND METHODS: A total of 225 women in the reproductive age group attending the Department of Gynecology were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All patients who tested positive on screening then underwent a colposcopy-guided biopsy. The Pap smear of a low-grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was the chi-square test and results were computed using Statistical Package for the Social Sciences (SPSS) version 12.0. RESULTS: Out of 225 patients, acetic acid (VIA) was positive in 27 (12%) patients and the Pap smear was abnormal in 26 (11.7%). There were 15 LSIL, 6 high grade squamous intraepithelial lesions (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia, and 3 squamous cancers. The Pap smear had a sensitivity of 83%, specificity of 98%, and positive predictive value of 80% and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9% and negative predictive value of 96.5%. CONCLUSION: Since diagnostic values of VIA is comparable to Pap smear, and it performs well in detecting a high grade lesion, we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings.
AIM: To assess the role of visual inspection with acetic acid as an alternative to Pap smear and in screening program for cervical cancer in low resource settings. MATERIALS AND METHODS: A total of 225 women in the reproductive age group attending the Department of Gynecology were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All patients who tested positive on screening then underwent a colposcopy-guided biopsy. The Pap smear of a low-grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was the chi-square test and results were computed using Statistical Package for the Social Sciences (SPSS) version 12.0. RESULTS: Out of 225 patients, acetic acid (VIA) was positive in 27 (12%) patients and the Pap smear was abnormal in 26 (11.7%). There were 15 LSIL, 6 high grade squamous intraepithelial lesions (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia, and 3 squamous cancers. The Pap smear had a sensitivity of 83%, specificity of 98%, and positive predictive value of 80% and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9% and negative predictive value of 96.5%. CONCLUSION: Since diagnostic values of VIA is comparable to Pap smear, and it performs well in detecting a high grade lesion, we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings.
Authors: Michelle I Silver; Jeff Andrews; Charles K Cooper; Julia C Gage; Michael A Gold; Michelle J Khan; L Stewart Massad; Valentin Parvu; Rebecca B Perkins; Mark Schiffman; Katie M Smith; Nicolas Wentzensen Journal: Obstet Gynecol Date: 2018-09 Impact factor: 7.661
Authors: Bayan Maraqa; Isam Lataifeh; Lian Otay; Osama Badran; Yasar Qutaiba Nouri; Ibtihal Issam; Maysa Al Hussaini Journal: Asian Pac J Cancer Prev Date: 2017-11-26
Authors: Divya Pathania; Christian Landeros; Lucas Rohrer; Victoria D'Agostino; Seonki Hong; Ismail Degani; Maria Avila-Wallace; Misha Pivovarov; Thomas Randall; Ralph Weissleder; Hakho Lee; Hyungsoon Im; Cesar M Castro Journal: Theranostics Date: 2019-11-26 Impact factor: 11.556