Comparing the efficacy of visual inspection with acetic acid and lugol’s iodine as a screening tool for detecting cervical lesions in asymptomatic women of reproductive age group with colposcopy and biopsy in a tertiary care hospital

Kavitha Marimuthu, Malarvizhi Loganathan


Background: A quarter of global burden of carcinoma cervix is experienced in India, where about 1, 26,000 new cases and 71,000 deaths attribute to cervical cancer are estimated to occur each year. Cervical cancer constitutes 15-55% of all female cancer and value of age standardized incidence ranges from 17.2 to 55 per 1 lakh women in different region in India with 5-year survival rate of less than 40% as most are detected at advanced stage. The objective of present study was to identify the incidence of cervical lesions in sexually active asymptomatic women.

Methods: This prospective study conducted in a tertiary care hospital for 1 year. This study comprises study subject of 734 women who were attending general and gynecology OPD. All 734 patients were subjected to visual inspection and magnification (VIA/VILI), colposcopy and biopsy was done in the positive patients.

Results: Of 734 cases studied, colposcopy was positive in 97 (13.1%). Among 97 cases who were colposcopy positive, VIA/VILI was positive in 90 cases. Colposcopy guided biopsy was positive in 97 cases. The sensitivity of VIA/VILI in detecting preinvasive lesions was 91.84% and specificity was 100% when compared with colposcopy which has sensitivity 98.98% and specificity 100%.

Conclusions: There is an enormous increase in the incidence of cancer cervix in geometric proportion. This can be controlled only with the introduction of mass screening programme by magnavision in a coordinated way in low resource settings.


Biopsy, Cancer Cervix, Colposcopy, VIA, VILI

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Nandakumar A, Ramnath T, Chaturvedi M. The magnitude of cancer cervix in India. Indian J Med Res. 2009;130(3):219-21.

Sreedevi A, Javed R, Dinesh A. Epidemiology of cervical cancer with special focus on India. Int J Womens Health. 2015;7:405-14.

National Cancer Registry Programme (NCRP, ICMR). Development of an atlas of cancer in India 2001-2002. Bangalore. NCRP. 2004;I-II. Available from: www.

Sankaranarayanan R, Nene BM, Dinshaw K, Rajkumar R, Shastri S, Wesley R et al. Early detection of cervical cancer with visual inspection methods: a summary of completed and ongoing studies in India. Salud Publica Mex. 2003;45:S399-407.

Mayrand MH, Duarte-Franco E, Rodrigues I, Walter SD, Hanley J, Ferenczy A et al. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med. 2007;357:1579-88.

Sharp LK, Zurawski JM, Roland PY, O'Toole C, Hines J. Health literacy, cervical cancer risk factors, and distress in low-income African-American women seeking colposcopy. Ethn Dis. 2002;12(4):541-6.

Paavonen J. Human papillomavirus infection and the development of cervical cancer and related genital neoplasias. Int J Infect Dis. 2007;11(Suppl 2):S3-S9.

Yeole BB, Kumar AV, Kurkureet A, Sunny L. Population-based survival from cancers of breast, cervix and ovary in women in Mumbai, India. Asian Pac J Cancer Prev. 2004;5:308-15.