Acetic‐acid guided visual inspection vs. cytology‐based screening for cervical cancer in the Philippines
- 1 November 2003
- journal article
- clinical trial
- Published by Wiley in International Journal of Gynecology & Obstetrics
- Vol. 83 (2), 141-150
- https://doi.org/10.1016/s0020-7292(03)00265-0
Abstract
To compare the validity and acceptability of acetic-acid visualization (VIA), magnified acetic-acid visualization (VIAM), spatula+cotton swab-Papanicolaou (Pap) smear (SS), and cervical brush-Pap smear (CB) in the detection of precursor/early cervical cancer lesions. A total of 12992 women aged between 25 and 65 years from 14 Philippine centers were randomly allocated to the four tests. The gold standard was colposcopy with biopsy for positive/suspicious cases. Sensitivity rates [95% confidence intervals (CIs)] were 37 (CI, 26.8-48.5), 34.1 (CI, 24.8-44.8), 14.3 (CI, 6.4-27.8), and 19.1 (CI, 9.2-34.6) for VIA, VIAM, SS, and CB, respectively. Specificity rates were 90.7 (CI, 89.6-91.7), 90.7 (CI, 89-91.1), 97.5 (CI, 96.8-98), and 97.9 (CI, 97.3-98.4), respectively. Kappa for the Pap smear (PS) within centers ranged from -0.154 to 0.783, and between centers from -0.028 to 0.364. Screeners preferred CB; screened-women preferred VIA. The acetic-acid visualization and VIAM methods are recommended for initial cervical cancer screening in the Philippines.Keywords
This publication has 13 references indexed in Scilit:
- Two-stage cervical cancer screening: An alternative for resource-poor settingsAmerican Journal of Obstetrics and Gynecology, 2000
- Speculoscopy vs. the acetic acid test for cervical neoplasiaInternational Journal of Gynecology & Obstetrics, 2000
- Accuracy of the Papanicolaou Test in Screening for and Follow-up of Cervical Cytologic AbnormalitiesAnnals of Internal Medicine, 2000
- Visual inspection with acetic acid for cervical-cancer screening: test qualities in a primary-care settingThe Lancet, 1999
- Visual inspection of the uterine cervix after the application of acetic acid in the detection of cervical carcinoma and its precursorsCancer, 1998
- Improvement of Pap smear sensitivity using a visual adjunctive procedure: a co-operative Italian study on speculoscopy (GISPE)European Journal of Cancer Prevention, 1998
- Colposcopy, Cervicography, Speculoscopy and EndoscopyActa Cytologica, 1998
- Analysis of False-Negative and Underreported Smears in the Florence District Screening Program for Cervical CarcinomaTumori Journal, 1997
- Acetic acid visualization of the cervix: an alternative to cytologic screeningObstetrics & Gynecology, 1996
- Screening for cervical cancer by direct inspection.BMJ, 1992