Abstract

A hospital-based, prospective study was done in 350 women of 20-50 years to compare VIA with Pap smear for early detection of cervical dysplasia at Maternity Hospital, Thapathali, from May 2004 to December 2004. Pap smear was taken from each woman followed by VIA. Women with positive VIA and/or positive Pap smear were referred for colposcopy-directed cervical biopsy. The variables studied were age group, presenting complaint, age of marriage, parity, smoking habit and appearance of cervix. The incidence of positive VIA and Pap smear was 2.86 and 0.57 respectively. Pelvic pain was the most common presenting complaint. The majority of the women were married before 20 years of age. All women with either positive VIA and/or Pap smear were of parity two or above. There was no significant association between smoking and positive VIA (P=0.699) or Pap smear (P=0.397). Approximately 36.57% of the women screened had abnormal looking cervix. There were two women with high grade intraepithelial lesion (HSIL) and both were VIA positive and this was statistically significant (Fischer exact P=0.0007). Of the ten VIA positive women, on histopathological examination six showed chronic cervicitis, one acute cervicitis, one showed cervical intraepithelial neoplasia (CIN) II, one had normal finding and one was lost to follow up. VIA as a screening test for cervical neoplasia did not miss any lesion detected by Pap smear and confirmed by cervical biopsy.

Highlights

  • Cervical cancer has a major impact on the lives of women worldwide

  • VIA as a screening test for cervical neoplasia did not miss any lesion detected by Pap smear and confirmed by cervical biopsy

  • During the study period 2,180 women attended to the Gynecology out patient department (OPD) during the study period and 350 of them were enrolled

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Summary

Introduction

Cervical cancer has a major impact on the lives of women worldwide It is the second most common cancer among women in the world.[1] It constitutes 1551% of all female cancers.[2] According to the latest global estimate, 493,000 new cases of cervical cancer occur each year, of which, 409,400 (83%) occur in women of developing countries while only 84,400 cases occur in that of developed countries.[3] Cervical cancer has a long premalignant phase. If it is detected and treated in this phase, advanced disease can be prevented. The primary cause of carcinoma cervix is Human Papilloma Virus (HPV), the most common sexually transmitted infection worldwide

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