Objective: The aim of this cross-sectional study was to assess the role of visual inspection with acetic acid VIA as an alternative effective tool to cytology in screening for cancer cervix in low resource settings.
Study design: 3298 women were screened by Pap (Papanicolaou) smear and VIA. Colposcopy was done for all women. Positive cases on any screening test were subjected to cervical biopsy. All women with a positive VIA (200 including 86 Pap +ve), abnormal Cytology (23 were VIA -ve), or those with abnormal colposcopy (87 were Pap -ve and VIA -ve)) were subjected to cervical biopsy and were included in our study. Thus a total of 310 cases from whom cervical biopsy were taken were included.
Results: Of the women screened, VIA was positive in 200 (6%) and 109 (3%) were positive on Pap smear. Cervical biopsy was done on 310 cases. 191 (62%) biopsies were positive and 119 (38%) were negative. The sensitivity, specificity, positive predictive value and negative predictive value of VIA were 90%, 76%, 86% and 83% respectively. While that of Pap smears were 57%, 93%, 93% and 55% respectively. There were significant differences between the sensitivity and the negative predictive values (NPV) of both tests (P value ˂ 0.05)
Conclusion: VIA is an easy learning, inexpensive test, with higher sensitivity than Pap smear and with immediate availability to assess results. Thus, VIA represents a good method of cervical cancer screening especially in poorly resourced locations.
Trial registration: TCTR20140518001.
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