title: Cervical digital photography for screening of uterine cervix cancer and its precursor lesions in developing countries.
abstract: OBJECTIVE
  This study aims to evaluate and to compare the performance of cervical digital photography (CDP) to the visual inspection with acetic acid (VIA) and visual inspection with Lugol's iodine (VILI) methods for screening the uterine cervix cancer and its precursor lesions in developing countries.
  
  
  METHODS
  A cross-sectional study was performed in Brazil. 176 women were evaluated by VIA, VILI, CDP with acetic acid and CDP with Lugol's iodine. Kappa statistic was used to estimate the interobserver and intermethod agreement. Sensitivity, specificity and diagnostic accuracy of the four methods (VIA, VILI, CDP with acetic acid, CDP with Lugol's iodine) was calculated.
  
  
  RESULTS
  Interobserver agreement for CDP with acetic acid was K = 0.441 and for CDP with Lugol's iodine was K = 0.533; intermethod agreement of VIA and CDP with acetic acid, K = 0.559; and of VILI and CDP with Lugol's iodine, K = 0.507. Sensitivity and specificity of CDP with acetic acid were 84.00 and 95.83 %, and of CDP with Lugol's iodine were 88.00 and 97.26 %, respectively. The diagnostic accuracy of CDP with acetic acid and CDP with Lugol's iodine was 92.78 and 94.90 %, respectively.
  
  
  CONCLUSIONS
  This was the first study to assess the CDP with Lugol's iodine performance, which had similar performance to the CDP with acetic acid. CDP is considered a promising method for screening the uterine cervix cancer and its precursor lesions in developing countries.
authors: Faculdade de Medicina, Programa de Pós-Graduação em Medicina: Ciências Médicas, Porto Alegre, Brazil.
authors: Elise de Castro
authors: Ede C
authors: Hillmann
authors: Ricardo
authors: R
authors: Dos Reis
authors: Heleusa
authors: H
authors: Monego
authors: Márcia
authors: M
authors: Appel
authors: Luciano Serpa
authors: LS
authors: Hammes
authors: Waldemar Augusto
authors: WA
authors: Rivoire
authors: Edison
authors: E
authors: Capp
mesh_terms: D019342:Acetic Acid; D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D002584:Cervix Uteri / Q000473:pathology; D004396:Coloring Agents; D003430:Cross-Sectional Studies; D003906:Developing Countries; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D007454:Iodides; D008875:Middle Aged; D015588:Observer Variation; D010781:Photography; D011237:Predictive Value of Tests; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology*
chemical_list: D004396:Coloring Agents; D007202:Indicators and Reagents; D007454:Iodides; D019342:Acetic Acid; C010389:Lugol's solution