Visual inspection with acetic acid and cytology as screening methods for cervical lesions in Cameroon

Abstract

Objectives To assess the accuracy of visual inspection with acetic acid (VIA) as a screening method for cervical lesions. Methods VIA and cytological smears were carried out on the cervices of non-pregnant women aged 30–60 years with no previous history of cervical cancer. Cervices with aceto white lesions or positive Pap smears, and one in ten negative cervices (control), were biopsied. Results 5010 women were enrolled, 4813 (96.1%) were screened. 4767 (99.%) had adequate cytology smears. 574 (11.9%) had colposcopy. 1743 biopsies were obtained of which 528 were controls. The sensitivity of VIA was 70.4% versus 47.7% for Pap smear. VIA specificity was 77.6% versus 94.2% for Pap smear; PPV for VIA was 44.0% versus 67.2% for Pap smear; and NPV for VIA was 91.3% versus 87.8% for Pap smear. Conclusions VIA has acceptable test qualities and may in low resource settings be implemented as a large scale screening method.