Abstract
Context: With a quarter of all cervical cancers occurring in India, the risk for women to contract this condition is high. The burden remains high because cervical screening programs of adequate scale are lacking. Aims: To compare the performance of visual inspection with acetic acid and cervical cytology in south India. Setting and Design: A cross-sectional study was performed in three villages in one of the south Indian district by recruiting 668 healthy women to undergo VIA and conventional Pap smear examination. Method and Material: Women who had a positive result from any of these tests were subjected to colposcopy and biopsies (if necessary), and women with high-grade cervical intraepithelial neoplasia (CIN) were properly treated. Statistical Analysis: Data was analyzed using statistical software from www.OpenEpi.com Results: Overall test positivity was 21.4% for VIA and 2.24% for Pap smear (LSIL threshold), 1.04% for Pap smear (HSIL threshold). VIA was positive in 70% of the women with CIN 1, 75% of those with CIN 2, 66.66% of women with CIN 3 and in two of two (100%) of women with cancer. Approximately 10% of women with no detectable disease had an abnormal VIA. Conclusions: A combined use of VIA with the Pap test allowed specific detection of cervical abnormalities.
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