title: Diagnostic value of acetic acid comparing with conventional Pap smear in the detection of colposcopic biopsy-proved CIN.
abstract: OBJECTIVE
  To assess the role of visual inspection with acetic acid as an alternative to Pap smear and in screening program for cervical cancer in low resource settings.
  
  
  METHODS
  A total of 225 women in the reproductive age group attending the Department of Gynecology were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All patients who tested positive on screening then underwent a colposcopy-guided biopsy. The Pap smear of a low-grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was the chi-square test and results were computed using Statistical Package for the Social Sciences (SPSS) version 12.0.
  
  
  RESULTS
  Out of 225 patients, acetic acid (VIA) was positive in 27 (12%) patients and the Pap smear was abnormal in 26 (11.7%). There were 15 LSIL, 6 high grade squamous intraepithelial lesions (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia, and 3 squamous cancers. The Pap smear had a sensitivity of 83%, specificity of 98%, and positive predictive value of 80% and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9% and negative predictive value of 96.5%.
  
  
  CONCLUSIONS
  Since diagnostic values of VIA is comparable to Pap smear, and it performs well in detecting a high grade lesion, we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings.
authors.affiliation: Department of Obstetrics and Gynaecology, A. J. Institute of Medical Sciences, Deralakatte, Mangalore, Karnataka, India. divyahegde31@yahoo.co.in
authors.forename: Divya
authors.initials: D
authors.lastname: Hegde
authors.forename: Harish
authors.initials: H
authors.lastname: Shetty
authors.forename: Prasanna K
authors.initials: PK
authors.lastname: Shetty
authors.forename: Supriya
authors.initials: S
authors.lastname: Rai
mesh_terms: D019342:Acetic Acid; D000328:Adult; D001706:Biopsy; D003127:Colposcopy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*
chemical_list: D019342:Acetic Acid