title: Performance of a low cost magnifying device, Magnivisualizer, versus colposcope for detection of pre-cancer and cancerous lesions of uterine cervix.
abstract: OBJECTIVE
  To assess the performance of a low cost magnifying device (Magnivisualizer) compared to a standard optical colposcope for detection of precancerous and cancerous lesions of the uterine cervix.
  
  
  METHODS
  A total of 659 consecutive symptomatic women attending a gynecologic outpatient clinic underwent unaided visual inspection followed by cytology, visual inspection of the cervix using 5% acetic acid (VIA), and VIA under magnification (VIAM) with the Magnivisualizer. All women, independently of test results, were referred for colposcopic examination. Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases.
  
  
  RESULTS
  The detection rate for VIA positive lesions was 12% (134/659), while it was 29% for VIAM positive lesions (191/659). The sensitivities of detection of cervical intraepithelial neoplasia (CIN) 2 and higher lesions were 61.7% for VIA, 88.3% for VIAM, and 86.7% for colposcopy, with a specificity of 58.5% for VIA, 55.8% for VIAM, and 90.4% for colposcopy. The performance of colposcopy and VIAM was moderate (κ, 0.48; 95% confidence interval [CI], 0.41 to 0.54) for detection of CIN 1 and higher lesions and excellent (κ, 0.87; 95% CI, 0.82 to 0.94) for detection of CIN 2 and higher lesions.
  
  
  CONCLUSIONS
  In low resource settings, where colposcopic facilities are not available at the community level, a simple low-cost, handheld Magnivisualizer can be considered a valid option for detection of cervical precancerous and cancerous lesions. However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.
authors.affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India. singhveena52@yahoo.co.in.
authors.forename: Veena
authors.initials: V
authors.lastname: Singh
authors.affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Parashari
authors.affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India.
authors.forename: Pushpa
authors.initials: P
authors.lastname: Sodhani
authors.affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Sehgal
mesh_terms: D019342:Acetic Acid; D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods; D020681:Colposcopes; D003127:Colposcopy; D055088:Early Detection of Cancer / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D061848:Optical Imaging / Q000295:instrumentation* / Q000379:methods; D010044:Outpatient Clinics, Hospital; D015203:Reproducibility of Results; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D019342:Acetic Acid
keywords: Ambulatory care facilities; Colposcopy; Sensitivity and Specificity; Uterine cervical dysplasia; Uterine cervical neoplasms