Visual inspection of the cervix as a primary means of cervical cancer screening: results of a pilot study.
OBJECTIVE
To measure the effectiveness of unaided visual inspection (UVI) of the cervix as a primary means of cervical cancer screening.


METHODS
A cross sectional study.


METHODS
Five primary health care clinics in Mashonaland Province, Zimbabwe.


METHODS
1,000 women aged between 25 and 55 years.


METHODS
Sensitivity and specificity of UVI.


METHODS
1,000 women attending primary health care clinics were screened for cervical cancer by six qualified nurses. An unlubricated bivalve speculum was inserted into the vagina under good light to visualize the cervix and a cervical cytology specimen was obtained followed by visual inspection of the cervix stained by 4% acetic acid. All women found to have abnormal cervices by visual inspection and/or by cervical cytology report were scheduled for colposcopy examination at Harare Central Hospital.


RESULTS
236 (23.6%) women had an abnormal cervical appearance after application with 4% acetic acid, out of which 157 (15.7%) were reported abnormal by cytology. True disease as defined by positive colposcopy and positive cytology was confirmed in 38 (3.8%) women. The sensitivity of UVI using colposcopy and cytology as a reference standard was 68.4%, specificity was 3.4%.


CONCLUSIONS
The results of this study suggest that naked eye inspection of the cervix after application of acetic acid is a practical alternative to cervical cytology in screening for cervical cancer in countries with few resources like Zimbabwe.
Chirenje
Z M
ZM
Department of Obstetrics and Gynaecology, University of Zimbabwe Medical School, Avondale, Harare.
Chipato
T
T
Kasule
J
J
Rusakaniko
S
S
D000085:Acetates; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015030:Zimbabwe / Q000453:epidemiology
D000085:Acetates