Vijayalakshmi, E (2006) Comparing the efficacy of Visual Inspection of cervix with acetic Acid (VIA) and Lugol's Iodine (VILI) with Pap Smear Cytology in screening for cancer cervix in asymptomatic women. Masters thesis, Madras Medical College, Chennai.
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Abstract
This is the study conducted at Kasturbha Gandhi Hospital for women and children to study the efficacy of visual inspection of cervix with acetic acid and lugol’s iodine in cervical cancer screening and to use it as an alternative strategy to papsmear in low resource country like India. Totally 500 cases were studied, most of them belonging to 30-40 yrs and socioeconomic status 3 0r 4. 172 cases were positive by visual inspection studies (VIA/VILI) almost 30 %. When these same 172 cases were subjected to biopsy, 1 case mild dysplasia, 2 cases of moderate dysplasia were reported showed. For 50 VIA negative cases biopsy was done and 1 case showed mild dysplasia and 49 cases were normal. The sensitivity calculated for visual inspection methods were sensitivity 98.9%, specificity 32.9%, positive predictive value 55.8%, negative predictive value 98 %. 2 cases of mild dysplasia was followed up and the 2 cases of moderate dysplasia underwent hysterectomy and the histopathological findings were also the same. VIA and biopsy was found significant at 0.000. Among the pap smear cytology results there were 53.2 % normal finding, 44.4 % inflammatory finding, 1.6 % LSIL/Atypical (6 cases LSIL, 2 cases Atypical), HSIL 0.8 % (4 cases). All the LSIL and Atypical cases underwent biopsy and was found to be chronic non specific cervicitis. These cases were followed up. The 4 HSIL cases were subjected to biopsy, 2 showed mild dysplasia, 2 moderate dysplasia. The sensitivity for papsmear in this study was 75%, specificity 94.6%, positive predictive value 25 %, negative predictive value 99.3 %. Thus the sensitivity for visual inspection studies was greater than that of papsmear cytology. Thus in a low resource country like ours where adequate number of cytologists are not available visual inspection with acetic acid and lugol’s iodine can be used as an effective screening technique for cervical cancer. CONCLUSION: • Visual inspection under Acetic Acid & Lugol. • Smple and easy. • Minimally dependent on infrastructure. • Low startup and sustaining cost. • Results available immediately. • May be possible to integrate into primary health care. • Can be done by paramedical trained staff. • It is effective and can be used as an alternate strategy in low resource settings where screening for cancer cervix by pap smear is not always possible due to inadequate cytologists.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Comparing ; efficacy ; Visual Inspection ; cervix ; acetic Acid (VIA) ; Lugol's Iodine (VILI) ; Pap Smear Cytology ; screening ; cancer cervix ; asymptomatic women. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 03 Dec 2017 10:00 |
| Last Modified: | 05 Dec 2017 01:38 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4159 |
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