Comparison of Sensitivity and Specificity of Papanicolaou Test, Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy in Cervical Cancer Screening in Patients with Secondary Immunodeficiency

Abstract

Cervical cancer is one of the most common problems in public health, especially in developing countries, which is identifiable by screening programs. This study aimed to compare the sensitivity and specificity of Papanicolaou test, visual inspection of cervix with acetic acid and colposcopy in immunodeficient patients. This examination on the test study was conducted on 135 immunodeficient patients who were referred to Afzalipour Hospital, Kerman, for cervical cancer screening from 2017 to 2018. In the first visit of all the patients, 3 separate tests of Papanicolaou test, VIA and colposcopy were simultaneously performed, and the results were recorded. To analyze the data, descriptive and analytical methods and SPSS software version 20 were used. Most of the cases were between 20 and 40 years old. The most frequency of immunodeficiency was noted among patients with AIDS (19.3%). According to the results of the colposcopy, VIA, Papanicolaou test and biopsy, 77%, 77.8%, 73.3% and 77% of the results were normal, respectively. Most patients were ASCUS in Papanicolaou test, and twenty-one of them were cervical intraepithelial neoplasia 1 (15.6%). Sensitivity, specificity, positive and negative predictive values of colposcopy were more than those of VIA and Papanicolaou test (74.1%, 92.3%, 74.1% and 92.3%, respectively). The results of the study showed that colposcopy is an appropriate method for cervical cancer screening in immunodeficient patients. Accordingly, at times when it is not possible to screen with other methods such as Papanicolaou test, this method may be used in preliminary evaluation.