title: Comparison of Pap smear, visual inspection with acetic acid, and digital cervicography as cervical screening strategies.
abstract: OBJECTIVE
  To compare the sensitivity, specificity, positive and negative predictive values (PPV and NPV), and accuracy of Pap smear, visual inspection with acetic acid (VIA) and digital cervicography (DC).
  
  
  METHODS
  This is a cross-sectional study on 100 women in the age group of 20-60 years, sequentially using the Pap test, the VIA, and the DC for screening. All women underwent colposcopic biopsy as the gold standard in comparing the methods.
  
  
  RESULTS
  Of the total of 100 women with the mean age 36.0 years, 17 cases were recognized positive for abnormal cervical cell by gold standard. The sensitivity, specificity, PPV, NPV, and accuracy of the Pap test, the VIA, and the DC were 23.5, 100, 100, 86.5, and 87%; 62.5, 98.8, 90.9, 93.2, and 92.9%; and 46.7, 97.6, 77.8, 91, and 89.8%, respectively, for cervical neoplasia.
  
  
  CONCLUSIONS
  The Pap test had low sensitivity but high specificity, whereas VIA had a high sensitivity in addition to being easy and low-cost. Adjuvant methods of screening such as VIA can be a valuable alternative to the Pap test for cervical cancer screening in low-resource settings.
authors.affiliation: Department of Obstetrics and Gynecology, Gynecology Cancer Research Center, Imam Hossein Hospital, Shaheed Beheshti Medical University, 1617763141 Tehran, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Khodakarami
authors.forename: Farah
authors.initials: F
authors.lastname: Farzaneh
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Aslani
authors.forename: Kamyab
authors.initials: K
authors.lastname: Alizadeh
mesh_terms: D019342:Acetic Acid / Q000191:economics; D000328:Adult; D001706:Biopsy; D003127:Colposcopy; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D055815:Young Adult
chemical_list: D019342:Acetic Acid