Comparison Between Pap Smear and Via As Screening For Cervical Lesions

V. Harshini, Amritha Bhandary, Suchithra Thunga


Introduction: An important reason for higher cervical cancer incidence in developing countries is lack of effective
screening programs like pap smear, aimed at detecting precancerous conditions before they progress to invasive
cancer. The potential difficulties in implementing cervical cytology based screening in low-resource settings have
prompted the investigation of accuracy of alternative low technology tests such as Visual inspection with acetic acid
application [VIA], Visual inspection with acetic acid application with magnification [VIAM], visual inspection on
Lugol’s Iodine application [VILI] in early detection of cervical neoplasia .In our study we compared pap smear with
VIA to study the accurarcy of VIA as it is simpler and easier technique to be used as screening in low resource
settings. Aim: This is a hospital based descriptive, prospective study to evaluate validity of pap smear and VIA
techniques as screening tests in identifying cervical lesions. Materials And Methods: After general and systemic
examination as a routine,visual local pelvic examination including visualisation of cervix and vagina per speculum
and the findings are documented in the proforma .Then VIA and pap smear are done in that order, if any of these
tests are positive then cervical biopsy will be taken and further advise to the subject is given. Results: A total of 313
women were involved in the study. The sensitivity of pap smear is 54.5% specificity is 98.9% while that of VIA
95.4% and 97.9%respectively. We found that VIA accuracy was comparatively more than that of pap smear.
Conclusion: In low resource settings, usefulness of VIA is more than that of pap smear. We suggest to perform VIA
in all the women inspite of having pap smear facility to improve detection rate of cervical lesions and provide better
patient councelling and treatment.


Pap smear, Cervix cancer, Visual inspection on acetic acid application [VIA].

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