Comparison of visual inspection of Cervix with acetic acid with conventional pap smear in the detection of colposcopic biopsy proved cervical intraepithelial neoplasia in women presenting in Tertiary Care Hospital

Abstract

Background: Cervical cancer grows in cervix, and infection from the Human Papillomavirus (HPV) is a must for the occurrence of cervical cancer. If a Pap test result is abnormal, the patient will have more tests to rule out or diagnose a precancerous condition. Visual Inspection with Acetic Acid (VIA) is a visualization of the female cervix with the naked eye after the application of acetic acid is a non-invasive procedure.

Objective: To compare Visual Inspection with Acetic Acid (VIA) with Papanicolaou (PAP) smear in the diagnosis of premalignant conditions of the cervix in women of reproductive age.

Methodology: This comparative study was carried out at the outpatient department of Gynae & Obstetrics, Services Hospital, Lahore from 30^th June to 29^th December 2022. The Non-probability convenient sampling technique was used. After taking the informed consent the acetic acid was applied and after 1 minute the entire cervix was examined for significant findings like thick and opaque areas and acetowhite having clearly demarcated edges. Colposcopic biopsy was also taken taking histological diagnosis as gold standard. The collected data was entered and analysis was done using version 22 of SPSS.

Results: The mean age of the patients was 41.8±13.7 years; the mean duration of marriage was 22.2±2.6 years. The sensitivity, specificity, PPV, and NPV of VIA for the detection of premalignant condition were 86.67%, 99.05%, 92.86%, and 98.11% respectively vs 66.67%, 98.09%, 83.33%, 95.37% respectively for Pap smear taking colposcopic biopsy as the gold standard.

Conclusion: According to our study naked-eye examination of the cervix with acetic acid is more accurate in detecting premalignant conditions of the cervix.