title: Effectiveness of cervical cancer screening using visual inspection with acetic acid in Peru.
abstract: OBJECTIVE
  To evaluate the effectiveness of screening using visual inspection with acetic acid (VIA).
  
  
  METHODS
  In a low-resource area of Peru in 2005-2008, a randomly selected sample of women who had previously screened negative by VIA and Pap (intervention group), and a group of eligible women previously unscreened by VIA (comparison group) were screened by VIA. The outcome measures were histologically confirmed cervical intraepithelial neoplasia (CIN) 2-3 and invasive cervical cancer.
  
  
  RESULTS
  There were 4252 women in the intervention group and 4392 in the comparison group. Histologically confirmed CIN 2 or worse was diagnosed in 31 (0.7%) and 115 (2.6%) women, and invasive cancer was diagnosed in 4 women (0.09%) and 43 women (1.00%), in the intervention and comparison groups, respectively. The adjusted odds ratio was 4.2 (95% confidence interval [CI], 2.7-6.4) for CIN 2 or worse, and 13.9 (95% CI, 4.9-39.6) for invasive cervical cancer in the comparison group.
  
  
  CONCLUSIONS
  A lower prevalence of CIN 2-3 and invasive cervical cancer was seen in women previously screened by VIA, as compared with women not previously screened by VIA, implying that a single VIA screening can lower the population risk for cervical cancer.
authors.affiliation: Unit of Non-communicable Diseases, Pan American Health Organization, Washington, USA. lucianis@paho.org
authors.forename: Silvana
authors.initials: S
authors.lastname: Luciani
authors.forename: Sergio
authors.initials: S
authors.lastname: Munoz
authors.forename: Miguel
authors.initials: M
authors.lastname: Gonzales
authors.forename: Jose M
authors.initials: JM
authors.lastname: Delgado
authors.forename: Mario
authors.initials: M
authors.lastname: Valcarcel
mesh_terms: D019342:Acetic Acid; D000328:Adult; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014626:Vaginal Smears / Q000379:methods; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology
chemical_list: D019342:Acetic Acid