Acetic acid visualization of the cervix to detect cervical dysplasia.
OBJECTIVE
To determine whether acetic acid visualization of the cervix can identify cervical dysplasia and improve detection of lesions missed by Papanicolaou test screening.


METHODS
During a 2-year period, patients attending family planning clinics for regular gynecologic examinations had acetic acid applied to the cervix, followed by gross visualization without magnification. Patients with suspicious acetowhite lesions and normal Papanicolaou tests were referred for colposcopic evaluation. Findings from these examinations and corresponding biopsy results were analyzed retrospectively.


RESULTS
Eighty-five women were referred for colposcopy because of abnormal acetowhite areas on the cervix. Thirteen patients (15%) had cervical intraepithelial neoplasia (CIN) (nine CIN I, four CIN II), 22 (26%) had koilocytosis, and 16 (19%) had benign histologic findings. In total, 51 patients had suspicious lesions at colposcopy for which biopsies were performed, and 34 (40%) had normal colposcopic examinations.


CONCLUSIONS
Acetic acid visualization of the cervix can detect dysplasia otherwise missed by Papanicolaou test screening. However, further refinements in technique are required to decrease false-positive findings and unnecessary referrals for colposcopy.
Van Le
L
L
Department of Obstetrics and Gynecology, University of Wisconsin, Milwaukee.
Broekhuizen
F F
FF
Janzer-Steele
R
R
Behar
M
M
Samter
T
T
D000085:Acetates; D019342:Acetic Acid; D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods; D065006:Papanicolaou Test; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014626:Vaginal Smears
D000085:Acetates; D019342:Acetic Acid