Detection of cervical dysplasia by acetic acid application to the cervix

ABSTRACT

To determine whether acetic acid visualization of the cervix can identify cervical dysplasia and improve detection of lesions missed by Papanicolaou test screening. During a 2 years period, 42 patients attending the Fertility Clinic for regular gynecologic examinations had acetic acid applied to the cervix, followed by gross visualization without magnification. Patients with suspicious aceto-white lesions and normal Papanicolaou tests were referred for colposcopic evaluation. Findings from these examinations and corresponding biopsy results were analyzed retrospectively. Forty two women were referred for colposcopy because of abnormal aceto-white areas on the cervix. Six patients [15%] had cervical intra-epithelial neoplasia [CIN], four CIN I, two CIN II, 11 [26%] had koilocytosis, and 8 [19%] has benign histologic findings. In total, 25 patients had suspicious lesions at colposcopy for which biopsies were performed, and 17 [40%] had normal colposcopic examinations. Acetic acid visualization of the cervix can detect dysplasia otherwise missed by Papanicolaou test screening. Also, acetic acid visualization of the cervix may be useful in settings where cervical screening opportunities are limited, such as third world countries and other underserved areas. However, further refinements in technique are required to decrease false-positive findings and unnecessary referrals for colposcopy