Visual inspection of the cervix with acetic acid for cervical intraepithelial lesions.
OBJECTIVE
Evaluation of visual inspection of the cervix with acetic acid (VIA) for screening cervical intraepithelial neoplasia.


METHODS
In this prospective study, 400 women were screened using the Papanicolaou (PAP) smear, VIA and colposcopy. Those who had positive results with any of the screening methods underwent large loop excision of the transformation zone (LLETZ). The sensitivity and specificity of each of the screening methods was analyzed.


RESULTS
The sensitivity of VIA (96.7%) was much higher than that of the Pap smear (50%), and almost as high as that of colposcopy (100%). The specificity of VIA (36.4%) was lower than that of the Pap smear (97%) and colposcopy (96.9%), resulting in high false-positive rates for VIA. Two cases of endocervical lesions were missed with VIA.


CONCLUSIONS
Visual inspection of the cervix with acetic acid is very sensitive for ectocervical lesions. The advantages of the VIA method are its low cost and ease of use (it can be used by paramedical workers), its high sensitivity and its immediate results (it is possible to "see and treat" at the first visit). Its main limitation is a high rate of false-positive results, which may lead to overtreatment if a "see and treat" policy is applied.
Goel
A
A
Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India. dr_anjugoel@yahoo.co.in
Gandhi
G
G
Batra
S
S
Bhambhani
S
S
Zutshi
V
V
Sachdeva
P
P
D019342:Acetic Acid; D000328:Adult; D002584:Cervix Uteri / Q000473:pathology; D003127:Colposcopy; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D065006:Papanicolaou Test; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears
D007202:Indicators and Reagents; D019342:Acetic Acid