Visual inspection for cervical cancer screening: evaluation by doctor versus paramedical worker.
Indian J Cancer
;
2004 Jan-Mar; 41(1): 32-6
Article
Dans Anglais
| IMSEAR
| ID: sea-50359
ABSTRACT
BACKGROUND:
In the absence of an effective cervical cancer screening programme, efforts are being made to explore the feasibility of using the existing infrastructure to develop effective low-cost screening methods.AIMS:
To evaluate and compare test performance of visual inspection of the cervix by a doctor and a paramedical worker. SETTING ANDDESIGN:
Gynaecology outpatient department (OPD), All India Institute of Medical Sciences, New Delhi; cross-sectional study. MATERIAL ANDMETHODS:
One hundred women with complaints of vaginal discharge, irregular bleeding, post coital bleeding or unhealthy cervix underwent visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) by a doctor and nurse, followed by colposcopy and biopsy. STATISTICAL ANALYSIS USED Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each test and compared. Concordance was determined by kappa statistics.RESULTS:
VIA by nurse had a higher sensitivity (100% versus 87.5%), but lower specificity (53% versus 63%) when compared with the doctor, but it was not statistically significant. There was moderate agreement between their VIA findings (kappa=0.56). VILI findings were comparable to that of the VIA, both by the doctor and nurse. There was almost perfect agreement (kappa=0.89) between VILI by the doctor and nurse.CONCLUSION:
Visual inspection can be performed reliably by trained paramedical workers and doctors and is an effective screening option in low resource settings.
Texte intégral:
Disponible
Indice:
IMSEAR (Asie du Sud-Est)
Sujet Principal:
Hémorragie utérine
/
Biopsie
/
Sujet âgé
/
Femelle
/
Humains
/
Maladies du col utérin
/
Tumeurs du col de l'utérus
/
Études de faisabilité
/
Dépistage de masse
/
Études transversales
Type d'étude:
Etude diagnostique
/
Étude observationnelle
/
Étude de prévalence
/
Étude pronostique
/
Facteurs de risque
/
Étude de dépistage
langue:
Anglais
Texte intégral:
Indian J Cancer
Année:
2004
Type:
Article
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