The value of visual inspection with acetic acid and Pap smear in cervical cancer screening program in low resource settings – A population-based study

This study aims to determine the diagnostic values of visual inspection with acetic acid (VIA) and Pap smear in a cervical cancer screening program at a community level in Vietnam. A cross-sectional analysis was obtained, including 1034 women of reproductive age from Thua Thien Hue Province, Vietnam...

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Veröffentlicht in:Gynecologic oncology reports 2018-05, Vol.24, p.18-20
Hauptverfasser: Huy, Nguyen Vu Quoc, Tam, Le Minh, Tram, Ngo Viet Quynh, Thuan, Dang Cong, Vinh, Truong Quang, Thanh, Cao Ngoc, Chuang, Linus
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Sprache:eng
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Zusammenfassung:This study aims to determine the diagnostic values of visual inspection with acetic acid (VIA) and Pap smear in a cervical cancer screening program at a community level in Vietnam. A cross-sectional analysis was obtained, including 1034 women of reproductive age from Thua Thien Hue Province, Vietnam from 09/2012 to 09/2013. Samples were taken from cervixes for Pap smear testing, followed by visual inspection with acetic acid. Subjects with abnormal VIA and/or positive cytology results were invited for colposcopy and biopsy. Histologic confirmed cervical intraepithelial neoplasia (CIN2+) served as gold standards for diagnostic values analysis. Abnormal VIA results were recorded in 87 cases (7.7%). The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of VIA for CIN2+ were 88.8%, 43.8%, 63.4%, 51.2% and 83.3%, respectively. Diagnostic values of Pap smear were 58.0%, 85.2%, 69.9%, 83.3% and 61.3% for its sensitivity, specificity, accuracy, PPV and NPV, respectively. VIA yielded high sensitivity but its accuracy is still limited in pre-cancerous lesions during cervical cancer screening. The Pap smear has acceptable sensitivity and specificity, but its false-negative rate is still high. We recommend a combination of different tests to increase the efficiency of screening in our community. •VIA has high sensitivity in pre-cancerous lesions and cervical cancer screening.•The sensitivity and specificity of Pap smear are acceptable.•Pap smear for triage after VIA(+) could increase the efficiency.
ISSN:2352-5789
2352-5789
DOI:10.1016/j.gore.2018.02.004