title: Screening for cervical cancer by direct inspection.
abstract: OBJECTIVE
  To assess the efficacy of visual screening for cervical cancer in the maternal and child health setting.
  
  
  METHODS
  Clinical and cytological screening.
  
  
  METHODS
  Maternal and child health centres, Delhi.
  
  
  METHODS
  44,970 women attending the centres from May 1988 to March 1991.
  
  
  RESULTS
  238 cancers in early stages (0-IIa) were detected cytologically and proved through biopsy. Prevalence of cancer in women defined as high risk through examination by speculum was 29/1000 as compared to 1.53/1000 among women with a normal looking cervix. Though only 11.4% women belonged to the high risk category, 63% had early stage cancer. If all women with bleeding symptoms were included in the high risk category, the yield of cancer would be 71.4% (170/238) by referring only 15.6% of women attending maternal and child health centres for further evaluation through cytology or colposcopy.
  
  
  CONCLUSIONS
  Though visual screening is a suboptimal strategy in comparison to the cytological screening, it may be useful where there is a heavy load of prevalent cancer and where cytological screening may not be available for years to come.
authors.affiliation: Institute of Cytology and Preventive Oncology (ICMR), Maulana Azad Medical College, New Delhi, India.
authors.forename: V
authors.initials: V
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Sehgal
authors.forename: U K
authors.initials: UK
authors.lastname: Luthra
mesh_terms: D001706:Biopsy; D005260:Female; D006801:Humans; D007194:India; D008403:Mass Screening / Q000379:methods*; D008430:Maternal-Child Health Centers; D009367:Neoplasm Staging; D010808:Physical Examination; D011237:Predictive Value of Tests; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*