Leucoplakia, leucokeratosis, and carcinoma of the cervix

Schiller, Walter

doi:10.1016/s0002-9378(38)90033-x

Cited by 42 publications

(9 citation statements)

References 21 publications

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“…When there was no other method for screening women for cervical cancer precursors in the 1930s, Schiller iodine test was well received by gynecologists in developed countries 12. As this test became widely used, its false positive outcomes became obvious and eventually its use was largely discontinued after the introduction of cytology 13.…”

Section: Discussionmentioning

confidence: 99%

Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India

Sankaranarayanan

Wesley

Somanathan

et al. 2003

Intl Journal of Cancer

183

154

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Simple and inexpensive methods based on visual examination of the cervix are currently being investigated as alternative methods of cervical screening. The test characteristics of visual inspection with 4% acetic acid (VIA), and Lugol's iodine (VILI) and conventional cytology were investigated in a crosssectional study involving 4,444 women aged 25 to 65 years in Kerala, India. While detection of any acetowhite area constituted a low-threshold positive VIA, detection of well-defined, opaque acetowhite lesions close to or touching the squamocolumnar junction constituted a high-threshold positive VIA test. Detection of definite yellow iodine nonuptake areas in the transformation zone close to or touching the squamocolumnar junction constituted a positive VILI test. Cytology was considered positive if reported as atypia or worse lesions. All screened women were evaluated by colposcopy and biopsies were directed in 1,644 women (37.0%), which allowed the direct estimation of sensitivity, specificity and predictive values. The reference diagnosis was based on a combination of histology and/or colposcopy. Cytology-based screening is not feasible in many developing countries at high risk for cervical cancer in view of the considerable financial, technical and manpower resources required for organizing such a program. Visual inspection-based screening is currently being evaluated as a potential alternative to conventional cytology in the early detection of cervical neoplasia. 1 We investigated the test characteristics of visual inspection of the cervix after application of 4% acetic acid (VIA) and visual inspection after the application of Lugol's iodine (VILI) in detecting high-grade cervical intraepithelial neoplasia (CIN 2-3) and invasive cervical cancer and compared these with that of cervical cytology, in a cross-sectional study, the results of which are reported in this article. MATERIAL AND METHODSA cross-sectional study was carried out during the years 1998 -2000 in Kerala, a southern state on the west coast of India. The study protocol was reviewed and approved by institutional review and ethics committees at the Regional Cancer Centre (RCC), Thiruvananthapuram, Kerala, and the International Agency for Research on Cancer (IARC), Lyon, France. Health education campaigns were conducted in different districts of Kerala to motivate women to seek cervical cancer prevention services in the early cancer detection clinics conducted by the community oncology division of the RCC. Apparently healthy women aged 25 to 65 years, who voluntarily attended these clinics, were invited to participate in the study. Pregnant women, and those who had already undergone hysterectomy or treatment for cervical precancer or cancer, were excluded from the study.The objectives and the methodology of the study were explained by a social worker and leaflets on cervical cancer prevention and early detection in the local language were distributed to the eligible women. A written informed consent was obtained from each woman willing to participa...

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Section: Discussionmentioning

confidence: 99%

Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India

Sankaranarayanan

Wesley

Somanathan

et al. 2003

Intl Journal of Cancer

183

154

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“…Introduced by Schiller in the 1930s, the test was initially performed by applying Lugol's iodine to the cervix (61). The test was rapidly replaced by Pap testing, which demonstrated improved specificity.…”

Section: Visual Inspection With Acetic Acid and "Screen And Treat" Prmentioning

confidence: 99%

Evidence-Based Cervical Cancer Screening: The Modern Evolution of the Pap Smear

Lappen¹,

Gossett²

2012

Evidence Based Medicine - Closer to Patients or Scientists?

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“…Historically, visual inspection of the cervix was the first method of screening of the cervix, introduced in the 1930s by Schiller, 19 who used Lugol's iodine to ‘increase the number of clinically diagnosed leucoplakias by making visible the lesions which would otherwise escape the naked eye’. It was however soon realised that this method of screening had very poor specificity and Schiller's test (as it was known) was rapidly replaced with cytology when it became available.…”

Section: Visual Inspection Screening Methodsmentioning

confidence: 99%

REVIEW: The prevention of cervical cancer in developing countries

Denny

2005

BJOG

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Cervical cancer remains the commonest cancer cause of death among women in developing countries, largely due to the failure to establish cytologically based cervical cancer screening programmes. There are many barriers to the establishment of screening programmes in poor countries ranging from limited financial, human and health resources to the complex infrastructural requirements of traditional screening programmes. Alternative approaches to cervical cancer prevention are currently being investigated, including primary prevention with prophylactic vaccines against human papillomavirus to alternative screening tests and protocols. These will be explored in this review.

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Leucoplakia, leucokeratosis, and carcinoma of the cervix

Cited by 42 publications

References 21 publications

Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India

Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India

Evidence-Based Cervical Cancer Screening: The Modern Evolution of the Pap Smear

REVIEW: The prevention of cervical cancer in developing countries

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