Open AccessA Population-Based Study of Visual Inspection With Acetic Acid (VIA) for Cervical Screening in Rural Nigeria
Author(s) -
Kayode Olusegun Ajenifuja,
Julia C. Gage,
Akinfolarin Adepiti,
Nicolas Wentzensen,
Claire Eklund,
Mary E. Reilly,
Martha L. Hutchinson,
Robert D. Burk,
Mark Schiffman
Publication year - 2013
Publication title -
international journal of gynecological cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.901
H-Index - 87
eISSN - 1525-1438
pISSN - 1048-891X
DOI - 10.1097/igc.0b013e318280f395
Subject(s) - medicine , cervical cancer , visual inspection , international agency , cervical cancer screening , developing country , population , rural area , cancer , gynecology , family medicine , environmental health , obstetrics , pathology , statistics , mathematics , economics , economic growth
Objective Cervical cancer is the most common gynecological cancer in developing countries. Visual inspection with acetic acid (VIA) was introduced to screen for cervical premalignant lesions in developing countries owing to the inability of many countries to implement high-quality cytologic services. We sought to compare VIA performance among different health workers in Nigeria. Methods In a population-based project, 7 health workers who had been screening women with VIA for approximately 2 years at local government health centers in rural Nigeria were retrained in a 2-week program using the International Agency for Research on Cancer training manual. Women from a rural village who had never had cervical cancer screening were recruited into the study. Each woman had cervical cancer screening by VIA, liquid-based cytologic test, and oncogenic human papillomavirus (HPV) DNA test. Results Despite similar participant characteristics, across all age groups, providers had wide ranges of VIA results; 0% to 21% suspect cancer and 0% to 25% were VIA positive. Visual inspection with acetic acid was insensitive compared to a combination of cytologic and HPV tests. Conclusion In our study, VIA was not reproducible, nor was it sensitive compared to cytologic and HPV tests.