Comparison of Visual Inspection with Acetic Acid and the Pap Smear for Cervical Cancer Screening

2017 ◽  
Vol 62 (1) ◽  
pp. 34-38 ◽  
Author(s):  
Parul Sinha ◽  
Pritika Srivastava ◽  
Anand Srivastava
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Visual Inspection ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Test Accuracy ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College

Objective: To evaluate the efficacy of visual inspection with acetic acid (VIA) in the early detection of cervical cancer and compare it with the Pap smear. Study Design: This was a cross-sectional study conducted over a period of 3 months. A total of 316 patients who attended the Gynecology Outpatient Department of Era's Lucknow Medical College and Hospital, fulfilled the inclusion criteria, and gave their informed consent were included. Results: VIA was found positive in 38 patients (12.6%). Pap smear was positive in 31 patients (10.3%). Twenty-eight patients had a positive VIA and a positive Pap smear, 3 had a negative VIA and a positive Pap smear, 10 had a positive VIA and a negative Pap smear, and 34 had a negative VIA and a negative Pap smear. Conclusion: The sensitivity of VIA and the Pap smear was found to be nearly equal, 93.3 and 93.8%, respectively. The Pap smear was found to be more specific than VIA, i.e., 72.9 versus 60%. In terms of test accuracy, the Pap smear was found to have greater test accuracy, i.e., 77.3 versus 66.7% for VIA.

scholarly journals Visual Inspection with Acetic Acid (VIA) Positivity Among Female Sex Workers: a Cross-sectional Study Highlighting One-year Experiences in Early Detection of Pre-cancerous and Cancerous Cervical Lesions in Kampala, Uganda

2021 ◽  
Author(s):  
Gertrude Namale ◽  
Yunia Mayanja ◽  
Onesmus Kamacooko ◽  
Daniel Bagiire ◽  
Agnes Ssali ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Visual Inspection ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
One Year

Abstract Background: Although cervical cancer is preventable, most women in sub-Saharan Africa (SSA) do not receive routine screening and few treatment options exist. Female Sex Workers (FSWs) are among the Ugandan female population at highest risk of acquiring sexually transmitted infections (STIs) including HIV and human papilloma viruses (HPV), the cause of cervical cancer. We report one-year experiences of visual inspection with acetic acid (VIA) positivity among FSWs in the early detection of pre-cancerous and cancerous cervical lesions in Kampala, Uganda.Methods: Between June 2014 and July 2015, we enrolled FSWs into a cross-sectional study at a research clinic. The women were screened using the VIA method (application of 3-5% acetic acid to the cervix). All VIA positive women were referred to a tertiary hospital for colposcopy, biopsy, and immediate treatment (if indicated) at the same visit according to national guidelines. Data on socio-demographic, sexual behaviour, sexual reproductive health and clinical characteristics were collected. We used logistic regression to identify factors associated with VIA positivity.Results: Of 842 women assessed for eligibility, 719 (85%) of median age 30 (IQR 26, 35) were screened, and 40 (6%) women were VIA positive. Of the 24 histology specimens analysed, 6 showed inflammation, only 1 showed cervical intraepithelial neoplasia (CIN) 1, 13 women showed CIN2/3, while 4 women already had invasive cervical cancer. The overall prevalence of HIV was 43%, of whom only 35% were receiving ART. In the age-adjusted analysis, VIA positivity was more likely among women who reported having >100 life-time partners (aOR=3.34, 95%CI: 1.38-8.12), and HIV positive women (aOR=4.55; 95%CI: 2.12 - 9.84).Conclusion: We found a relatively low proportion of VIA positivity in this population. The experience from our program implies that the VIA results are poorly reproducible even among a category of trained professional health workers. VIA positivity was more likely among women with a high number of sexual partners and HIV infection. Interventions for improving cervical cancer screening should be recommended as part of HIV care for FSWs to reduce the disease burden in this population.

scholarly journals Comparison of Visual Inspection using Acetic Acid and Liquid Based Cytology for Cervical Cancer Screening in Rural Area: A Cross-Sectional Study

2021 ◽  
Author(s):  
Pragya Shree ◽  
Nupur Mittal ◽  
Vandana Verma
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Visual Inspection ◽  
Screening Method ◽  
Lower Abdominal Pain ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Liquid Based Cytology ◽  
Cytology Screening

Introduction: Cervical cancer is the primary malignancy in Indian women. The most significant method for untimely diagnosis of cancer cervix is cytology screening, but it is not possible to launch nationwide cytology screening programme of cervical cancer. So, this has lead to the development of low cost technology e.g., visual inspection of the cervix after application of acetic acid. Aim: To compare Visual Inspection using Acetic Acid (VIA) and Liquid Based Cytology (LBC) in evaluation of abnormal cervical lesions. Materials and Methods: This was a cross-sectional study conducted on 1600 women who fulfill selection criteria. Patients attending Gynaecology Outpatient Department (OPD) with the following signs and symptoms like vaginal discharge, abnormal uterine bleeding, lowback pain, contact bleeding, and lower abdominal pain were included. After taking informed consent, the participant was subjected to detailed history, physical examination, LBC, VIA and Colposcopy followed by biopsy (if required). The sensitivity and specificity of each test are determined and compared. Data entry and analysis were done using SPSS Inc., version 11.0. Results: In present study, VIA was more sensitive (92.06%) than the LBC (68.25%) for the detection of dysplasia. However, the specificities of VIA (56.76%) and LBC (54.05%) had not much difference. Positive Pedictive Value (PPV) of VIA was 78.38% and Negative Predictive Value (NPV) of VIA was 80.77% while PPV of LBC was 71.67% and NPV of LBC was 50%. The accuracy of VIA (79%) is higher than LBC (63%). Conclusion: The VIA is more sensitive screening modality than LBC. The accuracy of VIA is higher than LBC in detecting premalignant lesion which makes it a suitable and valuable alternative screening method to cytology in poor resource setting.

scholarly journals Visual inspection with acetic acid (VIA) positivity among female sex workers: a cross-sectional study highlighting one-year experiences in early detection of pre-cancerous and cancerous cervical lesions in Kampala, Uganda

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gertrude Namale ◽  
Yunia Mayanja ◽  
Onesmus Kamacooko ◽  
Daniel Bagiire ◽  
Agnes Ssali ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Visual Inspection ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
One Year

Abstract Background Although cervical cancer is preventable, most women in sub-Saharan Africa (SSA) do not receive routine screening and few treatment options exist. Female Sex Workers (FSWs) are among the Ugandan female population at highest risk of acquiring sexually transmitted infections (STIs) including HIV and human papilloma viruses (HPV), the cause of cervical cancer. We report one-year experiences of visual inspection with acetic acid (VIA) positivity among FSWs in the early detection of pre-cancerous and cancerous cervical lesions in Kampala, Uganda. Methods Between June 2014 and July 2015, we enrolled FSWs into a cross-sectional study at a research clinic. The women were screened using the VIA method (application of 3–5 % acetic acid to the cervix). All VIA positive women were referred to a tertiary hospital for colposcopy, biopsy, and immediate treatment (if indicated) at the same visit according to national guidelines. Data on socio-demographic, sexual behaviour, sexual reproductive health and clinical characteristics were collected. We used logistic regression to identify factors associated with VIA positivity. Results Of 842 women assessed for eligibility, 719 (85 %) of median age 30 (IQR 26, 35) were screened, and 40 (6 %) women were VIA positive. Of the 24 histology specimens analysed, 6 showed inflammation, only 1 showed cervical intraepithelial neoplasia (CIN) 1, 13 women showed CIN2/3, while 4 women already had invasive cervical cancer. The overall prevalence of HIV was 43 %, of whom only 35 % were receiving ART. In the age-adjusted analysis, VIA positivity was more likely among women who reported having > 100 life-time partners (aOR = 3.34, 95 %CI: 1.38–8.12), and HIV positive women (aOR = 4.55; 95 %CI: 2.12–9.84). Conclusions We found a relatively low proportion of VIA positivity in this population. The experience from our program implies that the VIA results are poorly reproducible even among a category of trained professional health workers. VIA positivity was more likely among women with a high number of sexual partners and HIV infection. Interventions for improving cervical cancer screening should be recommended as part of HIV care for FSWs to reduce the disease burden in this population.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals Comparative evaluation of test characteristics of acetic acid, lugol’s iodine and toluidine blue stains in cervical cancer screening

2017 ◽  
Vol 6 (11) ◽  
pp. 4857
Author(s):  
Ankita Kumari ◽  
Neha Singh ◽  
Shaila Mitra ◽  
Reena Srivastav
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Toluidine Blue ◽  
Visual Inspection ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
Signs And Symptoms ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Lugol’S Iodine

Background: Cervical cancer rank second in female cancer and India alone account for one fourth of the global cervical cancer burden. The study was aimed to evaluate the diagnostic efficacy of acetic acid (3%), lugol’s iodine and toluidine blue (1%) in detection of abnormal cervical lesions.Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynecology, BRD Medical College, Gorakhpur over a period of one year from July 2016 to June 2017. The study included 200 women in age group 20-60 years with signs and symptoms suspicious of abnormal cervical lesion. The cases were subjected to detailed history, clinical examination, Pap smear, Visual inspection test, colposcopy followed by cervical biopsy.Results: Out of total 200 patients, 114 patients had acetowhite area on VIA (visual inspection with acetic acid) test, 113 were VILI (visual inspection with lugol’s iodine) positive and 107 women stained positive with Toluidine blue but only 88 showed biopsy proven pre-invasive and invasive lesions. So, sensitivity of acetic acid, lugol’s iodine and Toluidine blue was 81.8%, 84.09% and 90.9% respectively. Similarly, the specificity of the three stains were 62.5%, 65.17% and 75.8% respectively.Conclusions: Toluidine blue (1%) has proved to be significantly more sensitive and specific stain as compared to acetic acid (3%) and lugol’s iodine (50% dilution) in diagnosing pre-invasive and invasive cervical cancer. Hence, it may aid as an important tool in screening and treating precancerous and cancerous lesions.

scholarly journals Effectiveness of Visual Inspection with Acetic Acid and Pap Smear for Early Detection of Cervical Cancer among Women attending Gynecology O.P.D of Tertiary Level Hospital Gwalior (M.P) India

2021 ◽  
Vol 4 (1) ◽  
pp. 44-50
Author(s):  
Nisha Mehta ◽  
Saroj Singh
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Early Detection ◽  
Visual Inspection ◽  
Pap Smear ◽  
Sampling Technique ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Screening Programs ◽  
Level Hospital

Introduction: Cervical cancer is the fourth most common cause of cancer in women in the world and the second most common cancer among Indian women. About 23% of the global cervical cancer burden is beard by India alone. The screening of cervical cancer is commonly done by a pap smear, visual inspection of acetic acid, human papillomavirus DNA testing etc. These identify precancerous changes which when treated can prevent the development of cancer. The objectives of the study were to screen the patient at Gynecology OPD by visual Inspection with acetic acid (VIA) and Pap smear for early detection of cervical cancer and to evaluate the efficacy of visual inspection with acetic acid and Pap smear in the early detection of cervical cancer. Methods: A descriptive cross-sectional study was conducted among 60 women attending Gynecology O.P.D of a Tertiary Level Hospital, Gwalior (India) by non-probability purposive sampling technique between 1st August to 30th August 2017. Pap smear was taken from each woman followed by VIA. Women with positive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. Results: After the application of 3% VIA among 60 women, 16 (26.67%) developed acetowhite while 44 (73.33%) didn’t. While the result of Pap smear shows, 22 (36.66%) had an inflammatory smear, 6(10%) shows benign smear, 9(15%) bacterial vaginosis, 1(1.66%) squamous metaplastic cells, 12 (20%) shows adenocarcinoma and 10(16.66%) normal pap smear.  Conclusion: The study concludes that VIA and pap smear were effective methods for the early detection of cervical cancer. Visual inspection of the cervix after acetic acid application (VIA) is widely recommended as the method of choice in cervical cancer screening programs in resource-limited settings and developing countries because of its simplicity, cost-effectiveness and ability to link with immediate treatment.

scholarly journals Knowledge, attitudes and practices related to cervical cancer screening in adult women: a hospital based cross-sectional study

2020 ◽  
Vol 9 (12) ◽  
pp. 4974
Author(s):  
Neeti Nisha S. Jha ◽  
Neha Choudhary ◽  
Sunita Maheshwari
Keyword(s):  
Cervical Cancer ◽  
Screening Test ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Adult Women ◽  
Sectional Study ◽  
Cross Sectional ◽  
Face To Face ◽  
Attitudes And Practices ◽  
Level Of Knowledge

Background: The Pap smear is a reliable, inexpensive and effective screening test for cervical cancer; the second most common cancer among women worldwide. We aimed to determine women’s knowledge, attitudes and practice towards Pap smear and barriers for the screening in a public hospital.Methods: It was a hospital based cross sectional study on 300 women who were interviewed face-to-face with a structured questionnaire regarding their socio demographic features (8 questions), knowledge (20 questions), attitudes (7 statements) and practice (undertook test or not) towards Pap smear.Results: A total of 320 women were approached for interview of which 300 responded of which 33.33% had heard of cervical cancer. At least one symptom and one risk factor were known to 13.33% and 20% participants. Only 31.33% participants had heard, and 6.67% actually underwent screening test, however, 76.25% of the participants expressed a favourable attitude for screening.Conclusions: Education level influences attitude towards screening and actual practice depends on age, income, and marital status. This study shows that despite the fact that women had suboptimal level of knowledge regarding cervical cancer, their attitude is favourable for screening. The knowledge and practice of women was inadequate and needs to be promoted. 

scholarly journals Cervical Cancer and its Screening: A Cross-Sectional Study among Married Women in Sankhu, Kathmandu

2019 ◽  
Vol 3 (3) ◽  
pp. 519-523
Author(s):  
Sita Rijal ◽  
Alisha Rijal ◽  
Satish Kumar Deo
Keyword(s):  
Cervical Cancer ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Education Level ◽  
Married Women ◽  
Screening Tests ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pap Smear Test ◽  
Knowledge And Practice

Introduction: Cervical cancer ranks as the most frequent cancer among women between 15 and 44 years of age in Nepal. It is one of the preventable cancers. The effectiveness of cervical cancer screening depends to a great extent on the level of awareness. Objective: The objective of study is to explore the knowledge regarding cervical cancer and its screening and use of Pap smear test as a screening tool amongst the married women in Sankhu, Kathmandu. Methodology: A descriptive, cross-sectional study was conducted in April 2017 using interview guided questionnaire. One hundred and ten married women aged 30-60 years were included in the study to assess knowledge regarding cervical cancer and its screening. Among 110, 85 were eligible for screening tests but only 65 consented and participated in Pap smear tests. Multiple regression analysis was used to find out the association of knowledge and practice of cervical cancer and its screening with various variables. Results: Out of 110 participants, 54.5% belong to age groups 30-40 and mean age was 41.50 years. Though 62.5% knew about cervical cancer and 26.8% knew about pap smear test, only 22.7% participants had undergone cervical cancer screening test previously. Multivariateregression analysis showed that the lower education level was significantly associated with poor knowledge on cervical cancer (Odd ratio: 1.71, 95% Confidence interval 1.10-2.66; p=0.01) and poor practice of its screening (Odd ratio 1.92, 95% Confidence interval 1.27-2.89; p=0.00). Conclusion: The study reveals that education level has significant effect on knowledge and practice of screening tests. 

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