Agreement between visual inspection with acetic acid and Papanicolaou's smear as screening methods for cervical cancer.

OBJECTIVE

To determine degree of agreement between visual inspection with acetic acid (VIA) and Papanicolaou's (Pap) smear as screening methods for cervical cancer.

STUDY DESIGN

A cross-sectional study.

PLACE AND DURATION OF STUDY

Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012.

METHODOLOGY

Two hundred and fifty women in reproductive age group presenting with various gynaecological complaints were included in the study. A Papanicolaou's smear was taken and visual inspection with 5% acetic acid was done. VIA was reported as positive or negative according to acetowhite changes and cytology result was graded as CIN 1, 2, 3 and squamous carcinoma. Those women who showed positive result with either VIA or Pap smear or both were further subjected to colposcopic directed biopsy which was taken as gold standard. Results were computed using Statistical Package for Social Sciences (SPSS) version 16 and statistical test used was kappa.

RESULTS

Out of 250 women, VIA was positive in 55 (22%) patients and Pap smear was abnormal in 27 (10.8%). Histological diagnosis of CIN/cancer was made in 36 out of a total 62 patients who underwent biopsy.

CONCLUSION

There was a fair agreement between VIA and Pap smear, with VIA detecting more abnormalities than cytology. In the absence of Pap smear availability, VIA may be a reasonable cervical cancer screening method, especially in low resource settings.