A comparative study of cervical cancer screening methods in a rural community setting of North India.
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Date
2014-04
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Abstract
CONTEXT: Pap smear testing as a conventional cervical screening approach has limitations for implementation and aided visual cervical testing has
varying results in different regions. AIMS: The aim of this study is to demonstrate the performance of aided visual cervical screening tests as against
conventional Pap smear testing in a rural community setting of North India. SETTINGS AND DESIGN: This was a rural community based cross‑sectional
study. MATERIALS AND METHODS: All 7603 ever married women of age 30‑59 years surveyed in a pocket of Dadri Tehsil, Uttar Pradesh, India
were targeted for screening by Pap, visual inspection of cervix using acetic acid (VIA) and visual inspection of cervix using Lugol’s iodine (VILI)
methods. Screen positives were referred to colposcopy and confirmation by histology. STATISTICAL ANALYSIS USED: Detection of histological
cervical intraepithelial neoplasia (CIN) II + and CIN III + assessed separately by sensitivity, specificity and likelihood ratio’s and predictive values.
Analysis of data was performed by using IBM SPSS statstics software version 16.0. RESULTS: A total of 65.6%(4988/7604) eligible women of
30‑59 years age group in the target population were screened. Out of 4988, further analysis was performed on 4148 after excluding those who did
not complete all screenings, who lost to follow‑up and had missing histology results. Screen positivity rates by Pap (ASCUS and above), VIA and
VILI were 2.6%, 9.7% and 13.5% respectively. Sensitivity and specificity of detecting the CIN III+ lesions were 87.5 and 98.8% for Pap, 50.0%
and 96.7% for VIA and 50.0% and 95.7% for VILI respectively. CONCLUSIONS: VIA screening demonstrated as a feasible primary screening test
for detecting high grade CIN and as to perform better when the Pap test is not feasible.
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Keywords
Cervical cancer screening, cytology, rural community, visual inspection of cervix using acetic acid
Citation
Satyanarayana L, Asthana S, Bhambani S, Sodhani P, Gupta S. A comparative study of cervical cancer screening methods in a rural community setting of North India. Indian Journal of Cancer. 2014 Apr-Jun; 51(2): 124-128.