Diagnostic Accuracy of Visual Inspection with Acetic Acid (VIA) and PAP Smear in Diagnosing Cervical Cancer, Taking Histopathology as Gold Standard

Zubina Adnan; Ahmed Ahson Khan; Shazia Nayyar; Ayesha Nayyar; Zahida Anwar; Salman Ahsan

Zubina Adnan Assistant Professor Obs and Gynae Dept AJKMC /CMH Muzaffarabad
Ahmed Ahson Khan Assistant Professor, Pathology Department, AFIP Rawalpindi
Shazia Nayyar Associate Professor Obs and Gynae Department CMH Rawalpindi
Ayesha Nayyar Associate Professor, Pathology Department, Islamic International Medical College, Rawalpindi
Zahida Anwar
Salman Ahsan Shifa College of Medicine Islamabad

Keywords: Cervical cancer, PAP smear, histopathology

Abstract

Objectives: To compare the diagnostic accuracy of visual inspection with acetic acid (VIA) and PAP smear in diagnosing cervical cancer, taking histopathology as the gold standard.

Methodology: This Cross-sectional Validation study was conducted in the department of Obstetrics & Gynecology, Combined Military Hospital, Muzaffarabad, from 1st January 2019 to 30th June 2019. A total of 154 sexually active women with contact bleeding if married, cervical erosions, hypertrophied cervix on per speculum examination with a duration of symptoms >1 month and age 20-50 years were included.. All the patients were undergone PAP smear and visual inspection with acetic acid. The results of PAP smear and visual inspection with acetic acid (VIA) were compared with histopathology report.

Results: In this study, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of VIA smear in diagnosing cervical cancer was 85.53%, 88.46%, 87.84%, 86.25% and 87.01% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of PAP smear in diagnosing cervical carcinoma was 84.15%, 81.94%, 84.15% 81.94% and 83.12% respectively.

Conclusion: This study concluded that visual inspection with acetic acid (VIA) is more sensitive and accurate than PAP smear in diagnosing cervical cancer. Since diagnostic values of VIA are comparable to Pap smear, VIA can be used as a good alternative to PAP smear in mass screening of large population.