BACKGROUND: Only about one in seven visual inspection with acetic acid (VIA)-positive women has high-grade disease; further confirmatory testing could rule out false positives. OBJECTIVES: To determine if visual inspection with Lugol's iodine (VILI) or visual inspection with acetic acid and magnification (VIAM) can accurately confirm the presence of disease among rural Kenyan women referred to a district hospital because of a VIA-positive result at a primary health facility. METHODS: Referred women received cervical cytology and either VILI and/or VIAM as triage methods. All women were assessed by colposcopy and biopsied, if necessary. RESULTS: Of the 490 VIA-positive subjects referred, 332 (68%) attended the district hospital and received at least one of two triage tests and cervical cytology. The sensitivity and specificity for histologically-confirmed CIN 2 and 3 were 93% (14/15) and 32% (52/161) for VIAM; 100% (3/3) and 77% (49/64) for VILI; and 80% (16/20) and 48% (110/228) for cervical cytology. VILI reduced the number of false-positive screening results by 73%, without missing any true positives. CONCLUSIONS: VILI had comparable sensitivity and significantly higher specificity compared to VIAM and cervical cytology. VILI may be a promising triage test for screen-positive women in low-resource settings; additional research is required.
BACKGROUND: Only about one in seven visual inspection with acetic acid (VIA)-positive women has high-grade disease; further confirmatory testing could rule out false positives. OBJECTIVES: To determine if visual inspection with Lugol's iodine (VILI) or visual inspection with acetic acid and magnification (VIAM) can accurately confirm the presence of disease among rural Kenyan women referred to a district hospital because of a VIA-positive result at a primary health facility. METHODS: Referred women received cervical cytology and either VILI and/or VIAM as triage methods. All women were assessed by colposcopy and biopsied, if necessary. RESULTS: Of the 490 VIA-positive subjects referred, 332 (68%) attended the district hospital and received at least one of two triage tests and cervical cytology. The sensitivity and specificity for histologically-confirmed CIN 2 and 3 were 93% (14/15) and 32% (52/161) for VIAM; 100% (3/3) and 77% (49/64) for VILI; and 80% (16/20) and 48% (110/228) for cervical cytology. VILI reduced the number of false-positive screening results by 73%, without missing any true positives. CONCLUSIONS: VILI had comparable sensitivity and significantly higher specificity compared to VIAM and cervical cytology. VILI may be a promising triage test for screen-positive women in low-resource settings; additional research is required.
Authors: Rengaswamy Sankaranarayanan; Parthasarathy Basu; Ramani S Wesley; Cédric Mahe; Namory Keita; Charles C Gombe Mbalawa; Rameshwar Sharma; Amadou Dolo; Surendra S Shastri; Marius Nacoulma; Madi Nayama; Thara Somanathan; Eric Lucas; Richard Muwonge; Lucien Frappart; D Maxwell Parkin Journal: Int J Cancer Date: 2004-07-20 Impact factor: 7.396
Authors: Vijaya Srinivas; Holly M Nishimura; Poornima Jayakrishna; Karl Krupp; Purnima Madhivanan; SubbaRao V Madhunapantula Journal: Indian J Cancer Date: 2021 Jul-Sep Impact factor: 1.224
Authors: Megan J Huchko; Jennifer Sneden; Jennifer M Zakaras; Karen Smith-McCune; George Sawaya; May Maloba; Elizabeth Ann Bukusi; Craig R Cohen Journal: PLoS One Date: 2015-04-07 Impact factor: 3.240