Visual Inspection of Cervix with Acetic Acid (VIA): An Effective Method of Screening for Cervical Cancer

Abstract

Objective: To assess diagnostic accuracy of visual inspection of cervix with 3-5% acetic acid(VIA) as a screening method for early detection of cervical intraepithelial neoplasia and early cervical cancer.
Method: This cross-sectional study was conducted at Gynecology & Obstetrics Department Unit-1, Abbasi Shaheed Hospital, Karachi, from April 2017 to September 2018. Participants were included in the study through non-probability convenience sampling technique. Married, non-pregnant and sexually
active women aged between 21-50 years were included in the study. Demographic information and relevant history was taken followed by the procedure for VIA. Acetowhite changes were noted after application of 5% acetic acid on the cervix. The result of the test was documented as positive or negative. Colposcopy was done in all VIA positive cases and suspicious cases with abnormal looking cervix. Biopsy of the cervix was taken for histopathology to assess the results of VIA. SPSS version-20 was used for statistical analysis.
Results: There were 323 subjects with a mean age of 35.5 ± 7.6.Out of 323 participants only 6 were found VIA positive (1.86). On histopathology, only two cases were found positive (0.62%), one early invasive cervical cancer and one CIN1. Sensitivity, specificity, positive predictive value and negative predictive value of visual inspection of cervix after acetic acid application was 100%, 57%, 40%, 100%respectively and the diagnostic accuracy was 66.7%.

Conclusion: Visual inspection of cervix with 3-5% acetic acid is highly sensitive, screening method for cervical cancer. It is quite simple, affordable and better screening modality for detecting cervical cancer at an early stage.