[Sensitivity and features of visual inspection of cervix with acetic acid [VIA], as a screening test for cervical cancer]

ABSTRACT

Due to high false negative results of Pap smear, investigators are trying to design alternative tests for screening. One such option is Visual Inspection with Acetic Acid [VIA]. To determine the sensitivity and specificity of VIA as an alternative screening test for cervical cancer prevention. This is a prospective study on 401 based on demographic questioner, three separate Pap smear, referred to alzahra hospital Gynecology clinic. All the patients were given questionnaires of demographic characteristics and then underwent 3 separate tests [Pap smear, VIA and colposcopy] simultaneously. If colposcopic evaluation was abnormal, a sample biopsy was taken. The gold standard test is considered to be colposcopy-directed biopsy. Upon data collection, they were analyzed by statistical software SPSS version 14. As shown, 12 had abnormal Pap smear, 39 with positive VIA and 11 had abnormal colposcopy. Sensitivity of VIA was found to be 72.7%, and specificity 92.1%.Pap smear detected 83.3% CINI, 66.6% CIN III, 50% Invasive cancers whereas VIA detected 50% CINI and 100% CIN III and invasive cancers. Both tests yielded 3 false negative results. The number of false positives was higher for VIA. VIA is a more powerful screening test than Pap smear but its detection ability for CIN I is lower, compared with Pap smear. In order to minimize false negative results, we propose combination of VIA and Pap smear