Diagnostic Efficacy of Visual Inspection of Cervix with Acetic Acid for Cervical Intraepithelial Lesions

Abstract

Objective: Primary - To detect sensitivity and specificity of visual inspection of cervix with acetic acid keeping colposcopy directed cervical biopsy as gold standard Secondary - Comparison of visual inspection of cervix with acetic acid, cytology, colposcopy and colposcopy directed cervical biopsy Study Design: Cross sectional study carried over a period of 24 months from 1 November 2006 to 30 th October 2008. Setting: Study was carried out in the Out Patient Department ( OPD) at KLES Dr.Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Sample Size: Two hundred women Method: All women enrolled in study underwent Pap smear, VIA. colposcopy and colposcopy guided biopsy. IARC guidelines were used to interpret VIA results. The sensitivity, specificity, PPV, NPV, false-positive rate and false-negative rate were calculated for VIA, Pap smear and colposcopy with colposcopy guided biopsy as the gold standard. Results: In our study sensitivity and specificity of VIA found to be 86.95% and 72.51% respectively and that of Pap smear 37.68% and 92.36% respectively. Colposcopy showed higher sensitivity ( 94.20% ) and specificity ( 94.65% ) XI st Conclusion: VIA is a suitable primary screening procedure alternative to Pap smear as it has high sensitivity and negative predictive value. Women with positive VIA result should be subjected to colposcopy to avoid unnecessary treatment in disease free, as VIA has high false positive rate.