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Visual inspection of the cervix with acetic acid for cervical intraepithelial lesions
Author(s) -
Goel A.,
Gandhi G.,
Batra S.,
Bhambhani S.,
Zutshi V.,
Sachdeva P.
Publication year - 2005
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2004.09.018
Subject(s) - colposcopy , medicine , papanicolaou stain , cervical intraepithelial neoplasia , cervix , visual inspection , papanicolaou test , gynecology , radiology , obstetrics , cervical cancer , cancer , statistics , mathematics
Objective: Evaluation of visual inspection of the cervix with acetic acid (VIA) for screening cervical intraepithelial neoplasia. Methods: In this prospective study, 400 women were screened using the Papanicolaou (PAP) smear, VIA and colposcopy. Those who had positive results with any of the screening methods underwent large loop excision of the transformation zone (LLETZ). The sensitivity and specificity of each of the screening methods was analyzed. Results: The sensitivity of VIA (96.7%) was much higher than that of the Pap smear (50%), and almost as high as that of colposcopy (100%). The specificity of VIA (36.4%) was lower than that of the Pap smear (97%) and colposcopy (96.9%), resulting in high false‐positive rates for VIA. Two cases of endocervical lesions were missed with VIA. Conclusion: Visual inspection of the cervix with acetic acid is very sensitive for ectocervical lesions. The advantages of the VIA method are its low cost and ease of use (it can be used by paramedical workers), its high sensitivity and its immediate results (it is possible to “see and treat” at the first visit). Its main limitation is a high rate of false‐positive results, which may lead to overtreatment if a “see and treat” policy is applied.