Abstract
Background: Visual inspection of cervix after acetic acid is widely recommended at the method of choice in cervical cancer screening programme in resource - limited settings because of its simplicity and ability to link with immediate treatment. Cervical caner is the second most common cause of cancer selected morbidity and mortality among women in developing countries.
Method: The present study conducted from January 2017 to January 2018 on 200 patients was carried out in Department of Obstetrics and Gynaecology OPD and indoor admitted patients on women above the age 18 years.
Results: Majority of population belongs to the middle age group (25‑45 yrs), and the mean of age of patients was 38.2 years. On comparison of cytology and VIA, VIA was 87.5% sensitive and 86.45% specific, the positive predictive value (PPV) was only 21.21% whereas pap smear was 62.50% sensitive and 96.87% specific and PPV was 45.45%.
Conclusion: The majority of women in India, who belongs to the low socio economic status, pap smear in unaffordable to them. The time has come, to integrate VIA based screening programmes at the primary care level of health services, and to downstage cancer cervix in our country.
References
- Vedantham H, Silver MI, Kalpana B, et al. Determinants of VIA (Visual Inspection of the Cervix After Acetic Acid Application) positivity in cervical cancer screening of women in a peri-urban area in Andhra Pradesh, India. Cancer Epidemiol Biomarkers Prev. 2010;19(5):1373–1380.
- Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Womens Health. 2015;7:405–414.
- Bamanikar SA, Baravkar DS, Chandanwale SS, dapkekar P. Study of Cervical Pap Smears in a Tertiary Hospital. Indian Medical Gazette. 2014:250-254.
- Petry KU, Womann B, Schneider A. Benefits and Risks of Cervical Cancer Screening. Oncol Res Treat 2014;37(suppl 3):48-57
- Cervical cancer control in developing countries: Memorandum from a WHO meeting. Bulletin World Health Organ 1996;74:345-51.
- American Cancer Society. Global Cancer Facts & Figures 3rd Edition. Atlanta: American Cancer Society; 2015.
- Cervical Cancer: Statistic,s Cancer.Net Editorial Board, 01/2019
- Andrae B, Andersson TM, Lambert PC et al. Screening and cervical cancer cure: population based cohort study. The British Medical Journal 2012;344:e900.
- Bindal J, Agrawal S. Visual inspection of cervix with acetic acid in early diagnosis of cin and early cervical cancer. Int J Reprod Contracept Obstet Gynecol 2017;6:3564-8.
- Bobdey S, Sathwara J, Jain A, Balasubramaniam G. Burden of cervical cancer and role of screening in India. Indian J Med Paediatr Oncol. 2016;37(4):278–285.
- Sherris J, Herdman C, Elias C. Cervical cancer in the developing world. West J Med. 2001;175(4):231–233.
- Bosch FX, Munoz N. The viral etiology of cervical cancer. Virus Research 2002;89:183-90.
- Catarino R, Petignat P, Dongui G, Vassilakos P. Cervical cancer screening in developing countries at a crossroad: Emerging technologies and policy choices. World J Clin Oncol. 2015;6(6):281–290.
- Bhatla N, Mukhopadhyay A, Joshi S, Kumar A, Kriplani A, Pandey R M, Verma K. Visual inspection for cervical cancer screening; evaluation by doctor versus paramedical worker. Indian J Cancer 2004;41:32-6.
- Sankaranarayanan R, Wesley R, Somanathan T, Dhakad N, Shyamalakumary B, Amma NS, Parkin DM, Nair MK.Visual inspection of the uterine cervix after the application of acetic acid in the detection of cervical carcinoma and its precursors. 1998 Nov 15;83(10):2150-6.
- GoelPK, Bharti BB, Pandey CM, et al. A tertiary care hospital-based study of conventional risk factors including lipid profile in proven coronary artery disease. Indian Heart J 2003;55:234–
- Khan MJ, Castle PE, Lorincz AT, Wacholder S, Sherman M, Scott DR, Rush BB, Glass AG, Schiffman M. The elevated 10-year risk of cervical precancer and cancer in women with human papillomavirus (HPV) type 16 or 18 and the possible utility of type-specific HPV testing in clinical practice. J Natl Cancer Inst. 2005;97:1072–1079.
- Khan S, Jha R, Pant P. Accuracy of cytology, visual inspection with acetic acid or lugol’s iodine in cervical cancer screening. Nepal Journal of Obstetrics and Gynaecology 2007;2(2):48-53.
- Cronje HS, Parham GP, Cooreman BF, de Beer A, Divall P, et al. A comparison of four screening methods for cervical neoplasia in a developing country. Am J Obstet Gynecol 2003;188: 395-400.
Corresponding Author
Dr Km. Deepika
Senior Resident, Department of Obstetrics and Gynaecology, G.R. Medical College, Gwalior (M.P.), India
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.55
