Comparison Between Pap Smear and Via As Screening For Cervical Lesions

Abstract

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.