Role Of Visual Inspection With Acetic Acid And Hpv Dna Testing In Detection Of Cervical Intraepithelial Neoplasia – A Prospective Study

Abstract

Background and objective ABSTRACT Cervical cancer is an important public health problem that deserves urgent attention. In the developing countries control of cervical cancer is viable through screening modalities such as visual screening methods like visual inspection with acetic acid/visual inspection with Lugol’s iodine ( VIA/VILI ) and recently Human Papilloma virus deoxyribose nucleic acid ( HPV-DNA ) . This study was aimed to assess test performance of HPV DNA testing and VIA for detection of high grade cervical intraepithelial lesions and to assess the performance when HPV DNA testing and VIA are combined. Methodology This one year cross-sectional screening interventional study was conducted on a total of 204 women referred to Colposcopy Clinic, at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. Test results of VIA, colposcopy, HPV DNA and biopsy were obtained. Results Most of the women ( 50% ) had age between 30 to 34 years with the mean age of 36.75 ± 35.50 years. Most of the women ( 54.90% ) had studied upto college. 46.57% complained vaginal discharge and 33.82% backache. VIA, and HPV DNA test was positive results in 33.33% and 21.57%. The colposcopic findings among 16 women ( 7.84% ) showed positive test results which included 11 ( 5.39% ) cases of CIN 2, four cases ( 1.96% ) of CIN 3 and one case of SCC IX ( 0.49% ) . Of the 204 women, 73 ( 35.78% ) underwent biopsy. Among them, four women ( 5.48% ) revealed CIN 3 and one case ( 1.37% ) of SCC. Conclusion Overall, VIA and HPV positive tests showed diagnostic accuracy of 93.63% with positive likelihood ratio of 13.26 and negative likelihood ratio of 0.21 whereas VIA or HPV positive 55.39% diagnostic accuracy with positive likelihood ratio of 2.18 ( CI 95% ) .