International Journal of Contemporary Surgery
  • Year: 2016
  • Volume: 4
  • Issue: 1

Conventional Cytology Versus Visual Inspection Tests for Screening of Premalignant and Malignant Lesions of Cervix-A Study Involving East Delhi Population

1Assistant Professor, Department of Obstetrics & Gynecology, The Oxford medical college hospital & Research centre, Bangalore

2Director Professor, Department of Obstetrics & Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi

*Corresponding author: Dr Shilpa Kava, Assistant Professor, Department of Obstetrics and Gynaecology, The Oxford medical college hospital & Research centre, Yadavanhalli, Attibele Hobli, Anekal Taluq, Bangalore-562107

Online published on 18 February, 2016.

Abstract

(1) To detect cervical intraepithelial neoplasia (CIN) and cervical cancer using Papanicolaou test (Pap test), visual inspection tests (VIA, VILI), colposcopy and biopsy. (2) To evaluate the usefulness of VIA and VILI as an adjunct to improve sensitivity of cervical cytology. (3) To evaluate the role of VILI as a parallel screening method with VIA to enhance its test performance.

Experimental study conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional Pap test, VIA and VILI. Sensitivity, specificity, positive and negative predictive value of these tests were calculated individually, sequentially and in parallel. Women having positive results underwent colposcopy and biopsy if required.

All test positive cases n= 235, underwent colposcopy. Sensitivity, specificity, Positive predictive value(PPV) and Negative predictive value(NPV) of Pap test with ASCUS as cut off was 40%, 99.25%, 35.25% and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4% and 99.76% respectively. When Pap test, VIA and VILI were used in parallel sensitivity, specificity, PPV and NPV improved to 100%, 85.18%, 6.38% and 100% respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15.

(1) Pap test and visual techniques are complementary. (2) Combining the two tests can improve the detection of CIN and cervical cancer.

Keywords

Cervical intraepithelial neoplasia, Pap smear, visual inspection with acetic acid, visual inspection with Lugol's iodine, Colposcopy