Comparative study of Visual Inspection by Acetic Acid and Pap smear

Arifa Bari; S. Neelam; Z. Hayat

Abstract:

Objective: To compare the accuracy of visual inspection of cervix through acetic acid with Pap smear using colposcopic guided biopsy as gold standard. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at the Department of Obstet and Gynae, Fauji Foundation Hospital, Rawalpindi from May 2013 to December 2014. Materials and Methods: Total of 145 patients were included in the study. Demographic characteristics and VIA findings as positive, negative or unsure were recorded on a proforma. VIA positive and patients with unsure findings were asked to follow up in colposcopy clinic on a later date for colposcopic guided biopsy. Colposcopic directed biopsy was taken as the gold standard to assess visual inspection findings. SPSS version 17 was used for statistical analysis. Results: A total of 130 patients were finally recruited for our study.VIA was positive in 11%, negative in 77%, and unsure in 11%.Pap smear report was normal in 117 (90%) patients and abnormal in 13(10%) patients. Pap smear abnormality was CIN 1in 11, CIN 3 in1 and cervical cancer in one patient. Histopathology was normal in 121(93%) patients and abnormal (CIN and carcinoma) in 9(7%) patients. Histopathology showed cervicitis in 13%(out of normal histopathology report), CIN in eight(6%),cervical cancer in one patient(0.7%) and benign endometrial polyp in one patient(0.7%). The results were statistically significant with p value of <0.05. Sensitivity, specificity, PPV, NPV calculated for VIA were 100%, 96%, 53% &100% respectively vs 100%, 97%,75% and 100% for Pap smear, taking histopathology as gold standard. Conclusion: Visual inspection of the cervix after acetic acid application is an effective method of detecting pre-invasive phase of cervical cancer and a good alternative to Pap smear screening for cervical cancer in low resource settings.

research from:

• Foundation University Medical College

Year:

2018

Type of Publication:

Article

Journal:

Medical Forum Monthly

Volume:

29

Number:

2

Pages:

20-23

Month:

2