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Cervical cancer screening with naked‐eye visual inspection in Colombia
Author(s) -
Murillo Raul,
Luna Joaquin,
Gamboa Oscar,
Osorio Elkin,
Bonilla Jairo,
Cendales Ricardo
Publication year - 2010
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.2010.01.019
Subject(s) - colposcopy , cytology , visual inspection , medicine , obstetrics , gynecology , biopsy , cervical cancer , exfoliative cytology , cancer , radiology , pathology , computer science , artificial intelligence
Objective To assess the accuracy of visual inspection provided by nurses through combining acetic acid (VIA) and Lugol's iodine (VILI) in a low‐resource region of Colombia. Methods A cross‐sectional study with 4957 women was conducted to evaluate visual inspection techniques as the basis for see‐and‐treat approaches in cervical cancer control. All women underwent conventional cytology, VIA performed by nurses, and a combination of VIA and VILI. All women underwent colposcopy and biopsies were obtained for any positive test. Results A total of 762 women underwent biopsy, 4945 women were included in the analysis of conventional cytology, and 4957 were included in the analysis of VIA and VIA–VILI. Positivity rates were 1.3% and 4.3% for HSIL and LSIL cytology, 7.4% for VIA, and 10.1% for VIA–VILI. Sensitivity for cytology was 52.9% and 36.8% for LSIL and HSIL thresholds, 53.6% for VIA, and 68.1% for VIA–VILI. The corresponding specificity was 95.0%, 99.2%, 93.2%, and 90.8% respectively. The parallel combination of VIA–VILI and cytology LSIL‐threshold revealed the best performance as a screening strategy. Conclusion The use of VIA–VILI simulating colposcopic procedures and provided by nurses represents a good alternative for implementing see‐and‐treat programs in Latin America. Program constraints should be taken into account.