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Year : 2013  |  Volume : 12  |  Issue : 1  |  Page : 25-30

Diagnostic accuracy of VIA compared to Pap smear cytology in detecting premalignant lesions of the cervix

Department of Obstetrics and Gynaecology, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria

Correspondence Address:
A Omole-Ohonsi
PO Box 14578, General Post Office, Kano
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Source of Support: None, Conflict of Interest: None

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Background: In resource-poor countries, Papanicolau smear (Pap smear) is not usually available and evaluation of alternative cost-effective screening methods is a public health priority. Objective: To assess the accuracy of visual inspection with acetic acid (VIA) as a cervical cancer screening test in Aminu Kano Teaching Hospital, Kano, a tertiary hospital in a resource-poor country, i.e. Nigeria. Materials and Methods: This is a 3-year cohort study of 428 patients who had cervical cancer screening tests, with initial diagnosis following Pap smear and VIA, before the final diagnosis following colposcopy, between 1 June 2008 and 31 May 2011. Conventional accuracy estimates for VIA and Pap smear tests, using colposcopy as the reference standard, were done using tests of validity. Results: Among the 428 women who had Pap smear and VIA, 52 women had abnormal Pap smear while 95 had abnormal result following VIA, and 46 were confirmed following colposcopy to have precancerous lesions of the cervix, giving a period incidence of 10.8% for precancerous lesion of the cervix. In making the diagnosis of precancerous lesion of the cervix, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) estimates of VIA were 80.4%, 84.8%, 39.0%, and 97.3%, respectively, compared to 84.8%, 96.6%, 75.0%, and 98.1%, respectively, for Pap smear. Conclusion: The accuracy of naked eye VIA is comparable to that of Pap smear in detecting cervical dysplasia, which makes it a suitable and valuable alternative screening method to cytology in resource-poor countries.

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