High grade CIN diagnosis by combined visual inspection with Lugol's iodine and cytology in symptomatic women

Abstract Objective To investigate the diagnostic performance of combining the visual inspection with Lugol's iodine (VILI) and cytology screening to detect high-grade cervical intraepithelial neoplasia (CIN-2 or CIN-3) in symptomatic women, using histological examination as the standard reference test. Study design Cross-sectional referral study utilizing secondary data from 538 medical records from a clinic specialized in cervical pathology in Brazil. Results Although the sensitivity reached 96.8%, the specificity was only 8.1%, with positive predictive value of 18.3% and negative predictive value of 92.3%. Conclusion The combination of both tests proved to be highly sensitive, leading to a large decrease in the false negative results. This was achieved, however, at the cost of an excess in the rate of false positive results, thus making the combination unviable for screening in symptomatic women.