Correlation of cervical cytology and visual inspection with acetic acid in HIV-positive women

Akinwuntan, A L; Adesina, Olubukola Adeponle; Okolo, CA; Oluwasola, Olayiwola; Oladokun, Adesina; Ifemeje, A A; Adewole, I F

doi:10.1080/01443610802259977

Cited by 37 publications

(37 citation statements)

References 17 publications

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“…This varied from other studies conducted in this environment [12, 13] but agreed with a study conducted in India [14]. However, in these other studies [15–17], VIA was generally more sensitive but less specific than Pap smear in contrast to this study.…”

Section: Discussionsupporting

confidence: 88%

ecancermedicalscience

Albert¹,

Oguntayo²,

Samaila³

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This article is a comparative study of two screening methods for pre-invasive lesions of the cervix. The Papanicolaou (Pap) smear, an old and tested screening method, is compared with the findings from visual inspection of the cervix following acetic acid (VIA) wash. VIA is a new screening method being advocated by the World Health Organization as an alternative to Pap smear in low-resource settings.Objective:The objective of this article is to compare the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of VIA and Pap smear.Methods:This was a comparative study carried out in the postnatal clinic of Ahmadu Bello University Teaching Hospital, Zaria. Pap smear samples were taken by the researcher. Samples were fixed in 95% ethyl alcohol and taken to the Pathology Department for interpretation. The cervix was then painted with 3–5% VIA and observed for aceto-white lesions. Suspected areas were biopsied and transported to the Pathology Department for interpretation. Patients with positive Pap smear results were also called back for biopsy. Biopsy served as the reference standard.Results:There were 351 samples that were suitable for statistical analysis. The sensitivity of VIA was 60%, specificity 94.4%, positive predictive value 50%, negative predictive value 99.4%, and accuracy was 98.6%. Pap smear had a sensitivity of 60%, specificity of 100%, positive predictive value of 100%, negative predictive value of 99.4%, and accuracy of 99.4%.Conclusions:VIA had a comparable result with Pap smear. It should be incorporated into our national screening programme to complementthe cervical cytology in low-resource settings similar to ours.

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Section: Discussionsupporting

confidence: 88%

ecancermedicalscience

Albert¹,

Oguntayo²,

Samaila³

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“…In one study of 205 women correlating VIA with cytology with biopsy as the standard, VIA was more sensitive than Pap smear (76% vs. 57%, respectively) but less specific (83% vs. 95%, respectively); PPV for VIA was only 34% but was also low for cytology at 55%, but NPV for both techniques was high (97% for VIA, 95% for cytology). The prevalence for CIN in this patient population was 10.2% (Akinwuntan 2008). More recently VIA, HPV testing and cytology were compared to colposcopically-directed biopsy in 498 women in Kenya.…”

Section: Alternatives To Cervical Cytologymentioning

confidence: 99%

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

Anderson¹,

Lu²,

Sanghvi³

et al. 2012

Cancer Prevention - From Mechanisms to Translational Benefits

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“…[49] These findings buttress WHO suggestion that VIA could be used for mass screening in low-resource countries like Nigeria to reduce the burden of cervical cancer. [5,50] Although the sensitivity and specificity of VIA were found to be low, it could still be used as an alternative to Pap smear for mass screening of women in low-resource countries like Nigeria. This will go a long way to reduce the incidence of cervical cancer in these countries since most of these women do not have access to Pap smear facilities which in most instances are provided only in tertiary hospitals.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of cervical dysplasia and associated risk factors among women presenting at a primary care clinic in Nigeria

Mosuro¹,

Ajayi²,

Akin-Tunde³

et al. 2015

J Basic Clin Reprod Sci

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A B S T R A C TBackground: Cervical cancer is a global burden, with increasing incidence and mortality especially in developing countries where there are no clearly define national protocols or guidelines for effective screening and prompt treatment of cervical dysplasia (precancerous condition of the cervix). Most screening facilities are located in the tertiary hospitals, which are mostly not readily accessible to patients because of fear and bureaucracy of accessing services at these tertiary hospitals. In Nigeria, cervical cancer is the second most common female malignancy after breast cancer and national guidelines on effective screening is not readily available. At the general outpatients' Clinic, University College Hospital, Ibadan, screening is not well-established and patients are referred to the gynecology clinic for papanicolaou (Pap) smear, which result in poor compliance as a result of the protocol involved. Aim: To asess the prevalence and risk factors for abnormal cervical cancer screening amongst patients of the Primary Care Clinic at UCH, Ibadan, towards justifying expansion of cervical cancer screening service points in tertiary health institutions in Nigeria. Subjects and Methods: A cross-sectional study using the self-administered structured questionnaire on questions relating to the socio-demographic characteristics and lifestyle behavior including sexual history, after which Pap smear and visual inspection of the cervix with acetic acid were performed. Two hundred and eighty consented women aged 20-65 years were interviewed by one of the researchers between June and August 2012 using interviewer-administered structured questionnaires. The questionnaire sought information on their sociodemographic characteristics, and lifestyle behavior including sexual history, after which Pap smear and visual inspection of the cervix with acetic acid were done, respectively, for all the respondents at no cost. The results were analyzed using Statistical Package for Social Sciences (SPSS) version 11. Cross-tabulation was used to explore statistical associations between categorical variables. Variables were summarized using frequency distribution, means, proportions, and findings were presented in tables, histograms and pie charts. Chi-square statistic was used to assess the association between categorical variables. The level of significance was set at P < 0.05. Result: The mean age of the women was 42.5 (11.1) years, and their modal age was 30-39 years. The majority, 92.2% (258/280) of the women were Yoruba. Two hundred and twenty-eight (81.4%) of the women were married with majority 149 (65.4%) in the monogamous union. Two hundred and thirteen (76.1%) of the women had abnormal cervical cytology. One hundred and sixty-six (77.9%) of the women with abnormal cytology had inflammatory smears, 33 (15.5%) and 6 (2.8%) had mild and moderate dysplasia, respectively, while the remaining 8 (3.8%) had atypical cells. The prevalence of cervical dysplasia among all the women was 13.9% (39/280), with mild dysplasia acc...

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Correlation of cervical cytology and visual inspection with acetic acid in HIV-positive women

Cited by 37 publications

References 17 publications

ecancermedicalscience

ecancermedicalscience

Cervical Cancer Screening and Prevention for HIV-Infected Women in the Developing World

Prevalence of cervical dysplasia and associated risk factors among women presenting at a primary care clinic in Nigeria

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