SCREENING OF CERVICAL PRE-INVASIVE LESIONS AND INVASIVE CANCER BY VISUAL INSPECTION AFTER APPLICATION OF ACETIC ACID (VIA) AND PAP’S SMEAR AT COMMUNITY HEALTH FACILITIES

Abstract

Objectives: This study aims to determine the abnormal rate and the diagnostic validity of VIA and Pap-smear in screening of cervical pre-invasive lesions and invasive cancer in community health facilities. Subjects and Methods: Cross-sectional description on 977 women aged of 21 – 70 years in 5 communes in two districts Huong Tra, Huong Thuy of Thua Thien Hue province during the time from December 2011 to October 2012. Women were concurrently examined by gynecologic examination, screened for cervical lesions with Pap’s smear and VIA. Cervical smears were processed by using Papanicolaou staining, and classified according to Bethesda 2001 nomenclature. VIA was carried out and results classified according to 2011Guidelines of the Ministry of Health. Women whose VIA or papsmears appeared abnormal will be invited for re-examination at the Hospital for colposcopy and biopsy if indicated. The study parameters include the abnormal rate of pap-smear and VIA and the diagnostic value of VIA and cytology. Results: The mean age of screened women was 38.9±9.5. Rate of positive Pap’s smear increased with age and number of pregnancies. Abnormal VIA results were recorded in 20 cases (2.0%). Detection rate of cervical pre-cancerous lesions by Pap-smear was 7.6%, in which the diagnosis of ASCUS/ H was 3.0%, AGUS 2.9%, LSIL 1.6% and HSIL 0.1%. Concordancerate of VIA and Pap’s smear was 92.2%. Diagnostic value of VIA had a sensitivity of 75%; specificity of 99.16%; Diagnostic value of cervical pap-smear had a sensitivity of 81.25%; specificity of 93.65%. Conclusion: Detection rate of cervical pre-cancerous lesions by Pap’s smear was 7.6%. The concordance rate of VIA and Pap’s smear was quitehigh, at 92.2%, Diagnostic value of VIA had a sensitivity of 75%; specificity of 99.16%; Diagnostic value of cervical pap-smear had a sensitivity of 81.25%; specificity of 93.65%. However, if possible performing a biopsy all patients were screened, the research results will be more accurate. Key words: Cervical pre-invasive lesions and invasive cancer