A study of visual inspection of cervix under acetic acid and visual inspection of cervix under Lugol's iodine for screening of carcinoma cervix

Authors

  • Sunita Kanash Department of Obstetrics and Gynecology, TNMC and BYL Nair Hospital Mumbai, Maharashtra, India
  • S. D. Shirodkar Department of Obstetrics and Gynecology, TNMC and BYL Nair Hospital Mumbai, Maharashtra, India
  • Swati Gawai Department of Obstetrics and Gynecology, LTMMC and Sion Hospital Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20193665

Keywords:

Cervical intraepithelial lesion, Screening of carcinoma cervix, VIA, Visual inspection of cervix under acetic acid, Visual inspection of cervix under Lugol's iodine, VILI

Abstract

Background: Carcinoma cervix is the most common cancer among women in developing countries. The objectives of the study were to study the sensitivity and specificity of visual inspection of  the cervix with acetic acid (VIA) and Lugol's iodine (VILI) for cervical cancer screening. To study the correlation of demographic data like age, socioeconomic status, education residential area, parity, age at marriage in premalignant lesion of  the cervix.

Methods: The present study was conducted in the department of Obstetrics and Gynecology  at a Tertiary Medical Care Center over a period of two years. Five hundred fifty women between 20-65 years of age who fulfilled the selection criteria were enrolled in our study. Positive tests for VIA was opaque aceto white lesion on applying 5% acetic acid or detection of definite yellow iodine non uptake areas with Lugol's iodine in the transformation zone or close to touching the squamocolumnar junction. Positive cases were scheduled for cervical biopsy. Ethical approval of the study protocol was obtained from the ethics committee of the institute.

Results: On down staging 7.2% (40/550) of cases  had an unhealthy cervix and 0.36% (2/550) with a suspicious cervix. VIA positive in 4.55% (25/550), VILI positive in 2.73% (15/550). Biopsy was taken from positive with VIA and VILI. On histology 2.9% (16) were chronic cervicitis, CIN I had (1), 0.2%, CIN II (2) 0.4%, CIN III (4) 0.7% and squamous cell carcinoma (2) 0.4% VIA sensitivity 72.22%, specificity 97.74%. VILI sensitivity 100%, specificity 98.89%.

Conclusions: VIA and VILI are simple, inexpensive, low resources technique. Both have high sensitivity and specificity.

References

Mahmmoobehs, Diane S, Philip EC. Cervical cancer prevention. Cervical screening, science in evolution. Obstet Gynecol Clin N Am. 2007;(34):739-60.

Sankarnarayan R, Esmy PO, Rajkumar R, Muwonge R, Swaminathan R, Shanthakumari S. Effect of visual screening on cervical incidence and mortalityin Tamil Nadu: a cluster-randomized trial. Lancet. 2007;4370(9585):398-406.

Sehgal A. Human Papilloma virus (HPV) and screening strategies forcervical cancer. Indian J Med Res. 2009;130:234-40.

Dinshaw KA, Shastri SS. Screening for cervical cancer in 3, India. Natl Med J India. 2001;14:1-3.

Shastri SS, Dinshaw K, Amin G, Goswami S, Patil S, Chinoy R, et al. Concurrent evaluation of visual, cytological and HPV testing as screening methods for early detection of cervical neoplasia in Mumbai, India. Bull World Health Organ. 2005;83:186-94.

Juneja A, Sehgal A, Sharma S, Pandey A. Cervical cancer 5. Screening in India: Strategies revisited. Indian J Med Sci. 2007;61:34-47.

Misra JS, Gupta HP, Das V. Assessing the feasibility of single 6. Lifetime PAP smear evaluation between 41-50 years of age as strategy for cervical cancer control in developing countries from our 32 years of experience of hospital-based routine cytological screening. Diagn Cytopathol. 2004;31:376-9.

Sankaranarayanan R, Chatterji R, Shastri SS, Wesley RS, Basu P, Mahe C, et al. Accuracy of human papillomavirus testing in primary screening of cervical neoplasia: Results from a multicentre study in India. Int J Cancer. 2004;112:341-7.

Goel A, Gandhi G, Batra S, Bhambhani S, Zutshi V, Sachdeva P. Visual inspection of the cervix with acetic acid for cervical intraepithelial lesions. Int J Gynaecol Obstet. 2005;88:25-30.

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Published

2019-08-26

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Original Research Articles