title: Comparing the results of Pap smear and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening.
abstract: BACKGROUND
  Cervical cancer is the most second common cancer among Iranian women. This study was carried out to compare the results of Pap smear method and Direct Visual Inspection (DVI) with 5% acetic acid in cervical cancer screening in Tabriz, Iran.
  
  
  METHODS
  This cross-sectional study was carried out in Alzahra Therapeutic-Educational Centre, Tabriz, Iran in 2013 on 1000 women. First, Pap smear was done for all women, and then the cervix exposed with 5% acetic acid by cotton swab for 30 seconds and observed under adequate light. At the end, women with abnormal results in Pap smear or DVI method were referred to colposcopy and biopsy. Test's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), LR+, LR- and confidence interval (CI) were determined (P < 0.05).
  
  
  RESULTS
  Nine-hundred and seventy-four (94.7%) cases were normal and had no abnormal findings and 26 (2.6%) participants had positive results in Pap smear or DVI test. Twelve women had abnormal Pap smear (nine women with atypical squamous cells of undetermined significance, ASCUS, three women with dysplasia, atypical endocervical, and low-grade squamous intraepithelial lesion, LSIL results) and 14 women had positive DVI (four women with human papillomavirus, HPV or koilocyte,) and one women with abnormality in both method had carcinoma in biopsy that referred to oncologist. In this study the sensitivity, specificity, PPV and NPV for DVI were 71.4%, 50%, 35.7%, and 81.8% respectively in comparison with 14.3%, 50%, 10%, and 60% for Pap smear.
  
  
  CONCLUSIONS
  As the DVI method has higher sensitivity and positive predictive value than Pap smear, it could be used as a useful method beside the Pap smear.
authors: Student Research Committee, Tabriz University of Medical Science, Tabriz, Iran.
authors: Shakiba
authors: S
authors: Pourasad-Shahrak
authors: Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Hanieh
authors: H
authors: Salehi-Pourmehr
authors: Professor of Gynecology, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran.
authors: Parvin
authors: P
authors: Mostafa-Garebaghi
authors: Road Traffic Injury Prevention Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Mohammad
authors: M
authors: Asghari-Jafarabadi
authors: Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
authors: Jamileh
authors: J
authors: Malakouti
authors: Alzahra Therapeutic Educational Hospital of Tabriz, Tabriz, Iran.
authors: Monireh
authors: M
authors: Haghsay
keywords: Cervical cancer; Pap smear; direct visual inspection
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