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Cytology versus visual inspection with acetic acid among women treated previously with cryotherapy in a low‐resource setting
Author(s) -
Cremer Miriam,
Bullard Kimberley,
Maza Mauricio,
Peralta Ethel,
Moore Elizabeth,
Garcia Lydia,
Masch Rachel,
Lerner Veronica,
Alonzo Todd A.,
Felix Juan
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.2010.06.022
Subject(s) - cryotherapy , endocervical curettage , medicine , colposcopy , ascus (bryozoa) , biopsy , gynecology , cervical cancer , cytology , cryosurgery , obstetrics , cervix , cancer , surgery , radiology , pathology , botany , ascospore , spore , biology
Objective To compare visual inspection with acetic acid (VIA) with conventional cervical cytology as a follow‐up cervical cancer screening method in women who had been treated previously with cryotherapy. Methods Salvadoran women screened with VIA and treated with cryotherapy within 3 years were eligible to participate. Study participants were rescreened with VIA, Pap smear, colposcopy, 4‐quandrant biopsy, and endocervical curettage. Results Of 147 women enrolled in the study, post‐cryotherapy VIA was positive in 39 women (26.5%; 95% CI, 19.6%–34.4%). Of these 39, 1 woman had CIN 1 or higher on biopsy. Post‐cryotherapy Pap smear was positive (ASCUS or higher) in 6 women (4.1%; 95% CI, 1.5%–8.7%). Of these 6, 2 women had CIN 1 or higher on biopsy. Post‐cryotherapy specificity was significantly higher for Pap compared with VIA (95.8% [138/144]; 95% CI, 91.2%–98.5% vs 73.6% [106/144]; 95% CI, 65.6%–80.6%; P < 0.001). Conclusion As the single‐visit approach for cervical cancer screening gains popularity, more women will have been treated with cryotherapy. Appropriate follow‐up screening is therefore vital. Cytology may be a more suitable screening method than VIA in low‐resource settings for women treated previously with cryotherapy.