Is visual inspection with acetic acid better than cervical cytology to screen women ≥40 years of age for carcinoma cervix? A cross-sectional study on proportion of screen-positive women (by VIA and cervical cytology) having CIN II/III lesion on cervical biopsy: difference between two age groups and among screening methods

Dasgupta, Samir; Bhattacharya, Sudhindramohan

doi:10.1007/s00404-012-2228-3

Cited by 11 publications

(15 citation statements)

References 22 publications

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“…Our study found that VIA's sensitivity drops a significant amount (from 56% for premenopausal women to 41% for postmenopausal women for CIN3+ p < 0.001, Supporting Information Table SA) when testing postmenopausal women compared to premenopausal women. This finding is at odds with other studies which have found similar non‐significantly different VIA sensitivity performance in premenopausal and postmenopausal women . This inconsistent performance could be due to a variety of factors including recruitment criteria, sampling methods, population characteristics, differing criterion standard or disease burden.…”

Section: Discussioncontrasting

confidence: 76%

Evaluation of multiple primary and combination screening strategies in postmenopausal women for detection of cervical cancer in China

et al. 2016

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As China's population ages, the importance of determining prevalence of cervical disease and accurate cervical cancer screening strategies for postmenopausal women is increasing. Seventeen population-based studies were analyzed to determine prevalence of cervical neoplasia in postmenopausal women. All women underwent HPV DNA testing, visual inspection with acetic acid (VIA) and cytology testing. Diagnostic values for primary and combinations screening methods included sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), referral rate and area under curve (AUC) were calculated using directed biopsy or four quadrants biopsy as reference standard. Premenopausal and postmenopausal women had equal HPV infection and cervical neoplasia rates (p > 0.05). HPV DNA testing CIN3+ sensitivity, specificity, PPV, NPV, referral rate and AUC were 97.9% (95% CI: 90.2-99.9%), 84.2% (95% CI: 82.8-85.5%), 9.9% (95% CI: 7.4-12.8%), 100% (95% CI: 99.8-100%), 17.2% (95% CI: 15.9-18.7%), 0.911, respectively. VIA values were 41.7% (95% CI: 28.4-55.9%), 94.5% (95% CI: 93.6-95.3%), 11.8% (95% CI: 7.5-17.3%), 98.9% (95% CI: 98.5-99.3%), 6.2% (95% CI: 5.3-7.1%) and 0.681, respectively. Values for VIA with HPV triage were 39.6% (95% CI: 26.6-53.8%), 99.2% (95% CI: 98.8-99.5%), 45.2% (95% CI: 30.8-60.4%), 98.9% (95% CI: 98.5-99.3%), 1.5% (95% CI: 1.1-2.0%) and 0.694, respectively. VIA and HPV DNA co-test values were 100% (95% CI: 94.0-100%), 79.5% (95% CI: 78.0-81.0%), 8.0% (95% CI: 6.0-10.3%), 100% (95% CI: 99.9-100%), 21.9% (95% CI: 20.4-23.4%) and 0.898, respectively. VIA sensitivity decreases significantly in postmenopausal women compared to premenopausal performance. HPV DNA testing maintains performance between pre- and postmenopausal women and is the most accurate primary modality for screening postmenopausal populations in low resource areas of China.

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Section: Discussioncontrasting

confidence: 76%

Evaluation of multiple primary and combination screening strategies in postmenopausal women for detection of cervical cancer in China

et al. 2016

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“…In addition, experience of the personel who performed the VIA testing has an impact on the accuracy of VIA testing (Parashari and Singh, 2013). However, another previous study showed no difference in the sensitivity and specificity of VIA testing performed in older women as compared with those performed in younger women (Sankaranarayanan et al, 2004;Sankaranarayanan et al, 2005;Dasgupta and Bhattacharya, 2012). In the elderly, regression of the transformation zone into the endocervix may diminish the adequacy and the sensitivity of VIA testing in detecting cervical dysplasia (Rochelson and Krumholz, 1983;Cremer et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities

Poomtavorn¹,

Suwannarurk²

2015

Asian Pacific Journal of Cancer Prevention

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“…High SIL incidence rates of 11 and 17% were also reported by Ambedkar et al [3] and Srivastava et al [4], respectively, in rural screenings. A moderate incidence of SIL ranging from 6.4 to 7.1% was reported in rural women by Das Gupta et al [5] and Deodhar et al [6, 7]. Verma et al [8] reported an SIL rate of 8.0% in a tertiary hospital in the rural area of Himanchal Pradesh, India.…”

Section: Discussionmentioning

confidence: 94%

Results of Cervical Cancer Screening in the Rural Population of Lucknow West, India, through a Camp Approach

Misra¹,

Srivastava²,

Gupta³

2018

Acta Cytologica

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Objective: Cytological screening was carried out in rural women of Lucknow West, India, through a camp approach to detect cervical cancer in its preinvasive phase and to see whether the primitive living conditions in the villages have any effect on the incidence of precancer and carcinoma of the cervix and the associated predisposing factors of cervical carcinogenesis. Study Design: During a span of 4 years (May 2013 to March 2017), a total of 135 camps were organized under the auspice of Era’s Lucknow Medical College and Hospital (Lucknow, India). Only 4,269 (31.2%) out of 13,500 women who were motivated and counseled attended the camp and 2,369 (55.1%) of them underwent a Pap smear examination. Results: The incidence of squamous intraepithelial lesions of the cervix (SIL) was found to be very high (18.2%) in the 2,369 women who were screened, but the majority of them were of a low grade. The SIL incidence was very high for all predisposing factors like gynaecological symptoms, age, and clinical lesions of the cervix. However, the SIL rate showed a rise with increasing parity. Candida albicans was more common in rural women (4.7%) than Trichomonas vaginalis (1.1%), and a low incidence of viral sexually transmitted diseases (STD) was seen. Conclusions: Organizing camps in the villages through proper counseling and motivation may help in the screening of larger numbers of women for early detection of cervical cancer, the adequate treatment of which will check the progression of the disease and thus minimize the incidence of carcinoma of the cervix and its associated mortality in the rural population of India.

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Abstract: Cytological screening is less sensitive in women ≥ 40 years while VIA has a uniform sensitivity for both groups.

Cited by 11 publications

References 22 publications

Evaluation of multiple primary and combination screening strategies in postmenopausal women for detection of cervical cancer in China

Evaluation of multiple primary and combination screening strategies in postmenopausal women for detection of cervical cancer in China

Accuracy of Visual Inspection with Acetic acid in Detecting High-Grade Cervical Intraepithelial Neoplasia in Pre- and Post-Menopausal Thai Women with Minor Cervical Cytological Abnormalities

Results of Cervical Cancer Screening in the Rural Population of Lucknow West, India, through a Camp Approach

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