Is visual inspection with acetic acid (VIA) a useful method of finding pre-invasive cervical cancer?

Abstract

Is visual inspection with acetic acid (VIA) a useful method of finding pre-invasive cervical cancer? Maliheh Arab1, *, Atefeh Moridi2 , Ghazaleh Fazli3 , Robabeh Ghodssi-Ghasemabadi4 , Maryam Maktabi5 , Samaneh Saraeian6 , Mahdie Sanati7 1Gynecology-Oncology, Cancer Research Center, Shahid Beheshti University of Medical Sciences, 1983963113 Tehran, Iran 2 Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, 1983963113 Tehran, Iran 3Department of Developmental Biology, Science and Research University of Tehran, 1417466191 Tehran, Iran 4Department of Biostatistics, Tarbiat Modares University, 14117-13116 Tehran, Iran 5Obstetrics & Gynecology, Arak University of Medical Sciences, 38156879 Arak, Iran 6Obstetrician & Gynecologist, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, 1983963113 Tehran, Iran 7Developmental biology, Science and Research University of Tehran, 1417466191 Tehran, Iran *Correspondence: drmarab@sbmu.ac.ir (Maliheh Arab) DOI:10.31083/j.ceog.2021.01.2209 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: July 04, 2020 Revised: October 15, 2020 Accepted: November 16, 2020 Published: February 15, 2021 Purpose of investigation: The prospects for eȞfective cytological screening in the majority of developing countries are limited. This study evaluated visual inspection with acetic acid (VIA) for the diagnosis of CIN 2-3 in case findings. Materials and Methods: In this prospective study, 1437 asymptomatic women were screened using VIA followed by colposcopy-biopsy of all cases. The predictive eȞficacy of VIA was determined based on pathological confirmation of CIN 2-3 on colposcopy-directed biopsy. Results: In 388 (27%) out of 1437 cases, the VIA was positive. In 31 (2.1%) cases, CIN 2-3 was confirmed on cervical biopsy. The sensitivity, specificity and negative predictive value (NPV) of the VIA were 41.9%, 73.3%, and 98.2%, respectively. Conclusion: The present study confirmed the value of VIA for screening, with sensitivity of 41.9% and NPV of 98.2%. Future studies should determine the best place for VIA testing alongside other types of testing in screening algorithms. Keywords Screening; Cervical cancer; Cervical dysplasia; Colposcopy; Visual inspection with acetic acid; Iran