Gynecology & Obstetrics
Open Access

Abstract

Visual Inspection of the Cervix with (Acetic Acid or Lugol’s Iodine) for Cervical Cancer Screening

Hend S Saleh*, Azza A abd El Hameid, Hala E Mowafy, Hala E Sherif and Walid A Abdelsalam

Objective: To assess the visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) as alternative screening methods for cancer cervix.

Materials and methods: Comparative cross-sectional study was conducted on 1000 women with age range from 18 to 61 years were attending the obstetrics and gynecology Department in Zagazig university hospital from January2013 to October 2015. Each one was done Papanicolaou smear (PAP), visual inspection with 5% acetic acid (VIA) and with 5% Lugol’s iodine (VILI). All women underwent Colposcopy. Analyse of the sensitivity, specificity and predictive values of the results using colposcopic directed biopsy as reference was done.

Results: From 80 positive screening tests by (either PAP, VIA, VILI or colposcopy). Pap smear was positive in 14/80 (17.5%), including 4 cases of atypical squamous cell with undetermined significance (ASCU), 4 cases of low grade squamous cell intraepithelial lesion (LSIL) and 5 cases of high grade squamous cell intraepithelial lesion (HSIL) and one case with malignant cells. Biopsy was positive in 11/14 of PAP smear. VIA accounted positive in 23/80 (28.7%) and VILI results were positive in 12/80. Biopsy was positive in 21/23 for VIA and 8/12 was positive for VILI , The Pap smear had a sensitivity of 78.57%, specificity of 96.75%, and positive predictive value 75.12% and negative predictive value of 97.09%. VIA had a sensitivity of 91.30%, specificity of 85.33% and positive predictive value of 40.11% and negative predictive value of 98.05%. VILI had sensitivity of 66.54, specificity of 91.32, and positive predictive value 43.51% and negative predictive value of 98.31%.

Conclusion: Precancerous and cancerous lesions of the cervix could be well detected by VIA and VILI in low resource locality. Using both testes in matching improves the specificity of both to make them good options for screening of cancer cervix in this society.