title: [Diagnosis of cervical intraepithelial neoplasia by visual inspection with acetic acid among Chinese women: a meta-analysis].
abstract: OBJECTIVE
  To evaluate the performance of visual inspection with acetic acid (VIA) in preliminary screening of cervical cancer and its precancerous lesions among Chinese women by meta-analysis of diagnosis.
  
  
  METHODS
  Pubmed, Cochrane, Wanfang, CNKI and Weipu databases were employed to search for citations using the MeSH terms as "acetic acid", "cervical intraepithelial neoplasia", and "cervical cancer" both in Chinese and English. Additional relevant references cited in retrieval articles were also searched.40 pieces of research paper related with screening of cervical cancer and precancerous lesions of cervical cancer in Chinese women by VIA were collected. Bivariate random effects model was adopted using SAS 8.02.
  
  
  RESULTS
  Twenty-two studies including 23 330 cases were finally selected in the analysis, among which 19 studies were reported in Chinese and the other 3 in English. These studies were reported from 2004 to 2010 and the age-range of subjects was between 15 and 81 years old. Stratified analysis of diagnosis threshold showed that the pooled diagnostic odds ratio (DOR) of VIA for CIN1+ (4.11, 95%CI: 3.20 - 5.04) was similar to that for CIN2+ (4.45, 95%CI: 3.73 - 5.15). Either CIN1+ or CIN2+, the DOR in younger women (≤ 40 year) (4.22, 95%CI: 3.29 - 5.16; 4.53, 95%CI: 3.46 - 5.47) was also similar to it in older women (> 40 year) (3.66, 95%CI: 2.27 - 5.37; 4.26, 95%CI: 3.32 - 5.26). There was no difference in the screening performance between county-level doctors (DOR = 4.62, 95%CI: 3.13 - 5.93) and municipal-level doctors (DOR = 4.48, 95%CI: 3.71 - 5.16).
  
  
  CONCLUSIONS
  The screening performances of VIA were relatively consistent among different lesion grades and aging groups of Chinese women. After professional training, there was no difference in performance between county-level hospitals and municipal-level hospitals.
authors.affiliation: Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
authors.forename: Li-xuan
authors.initials: LX
authors.lastname: Wei
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Lan-wei
authors.initials: LW
authors.lastname: Guo
authors.forename: Yu-heng
authors.initials: YH
authors.lastname: Chen
authors.forename: Qian
authors.initials: Q
authors.lastname: Li
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.forename: Ni
authors.initials: N
authors.lastname: Li
mesh_terms: D019342:Acetic Acid; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000517:prevention & control
chemical_list: D019342:Acetic Acid