A Comparative Study Between Pap Smear And Visual Inspection With Acetic Acid (VIA) In Screening Of Cin And Early Cervical Cancer

ABSTRACT

Introduction: Present study was conducted to detect the specificity and sensitivity of each test for identifying cervical intraepithelial neoplasm (CIN) and cervical cancer by compå with the histology from positively screened women. Methodology: A prospective study was conducted in the department of obstetrics and Gynecology S.P. Medical College Bikaner on 500 gynecological cases. The PAP was evaluated by the Bethesda system and VIA was performed. All positive cases of VIA and pap‘s smear were scheduled for biopsy and histological evaluation. Statistically analysis was done. Results: The sensitivity of VIA was higher (63.16%) than that of Pap smear (52.63%). The specificity of VIA was lower (97.62%) as compared to Pap smear (99.13%). The positive predictive value of Pap smear was 83.33% and that of VIA was 68.57%. The negative predictive value of Pap smear was 96.22% and that of VIA was 96.99%. The diagnostic accuracy of VIA was 95.0% which was comparable to that of Pap smear (95.6%). Conclusion: VIA may be considered as an alternative to Pap smear in resource poor settings. However, in areas where cytology based screening is available, VIA may be useful as an adjunct to improve the sensitivity of cervical cytology.