Diagnostic Efficacy of Visual Inspection with Acetic Acid (VIA) in Cervical Cancer Screening in Women Aged 20-60 Years

Aim: To assess the efficacy of VIA as cervical cancer screening in women aged 20-60 years by comparing it with cytology, colposcopy and using cervical biopsy histopathology as gold standard. Methods: The study population consisted of 500 women. Freshly prepared 5 % acetic acid was applied to the cervix and inspected after one minute. Women were subjected to cytology, colposcopy and histopathology as well. Using histopathology as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of VIA, cytology and colposcopy was calculated. Statistical significance was calculated by P value 0.05. Results: VIA had higher sensitivity& negative predictive value of 78.04 %& 96.32 % respectively, than LBC and colposcopy. LBC& colposcopy had higher specificity and positive predictive value than that of VIA. VIA showed the highest percentage of false positives (54.3 %) while the lowest percentage of false negatives (21.9 %). Conclusions: VIA can be used as an initial screening test for cervical cancer in low resource countries like India. Cytology had high sensitivity and comparatively higher specificity and therefore can be used for screening in conditions when there are no financial constraints.