MounikaKuppili
Sree Mookambika Institute of Medical Sciences, Kanyakumari, IndiaTitle: Comparing the efficacy of VIA (Visual Inspection with Acetic Acid) and VILI (Visual Inspection with Lugol’s Iodine) of cervix with PAP smear cytology as a screening tool for detecting cervical lesions in asymptomatic women
Abstract
Background: Cervical cancer is one of the leading cancers with a rise in incidence even though it’s a preventable disease.PAP smear cytology being a standard screening tool is not feasible in India due to the lack of awareness, financial and technical constraints. In many clinical trials Visual inspection with acetic acid(VIA) and visual inspection with Lugol’s iodine(VILI) is considered as an alternative to cervical cytology for primary cervical cancer screening in low resource settings.
Aim of the Study: (I)The aim of the study is to compare the efficacy of VIA and VILI with PAP smear cytology in screening for cancer cervix, premalignant and malignant lesions of cervix so that VIA/VILI can be used in peripheral areas where cytology is not available. (II)Early detection and tretmeant of pre cancerous conditions before they progress to invasive cancer.
Methodology: This clinical study was conducted on 200 gynaecological patients who presented to Sree Mookambika Institute of Medical Sciences hospital satisfying the inclusion and exclusion criteria.
Results: In the present study,the sensitivity of VIA and VILI was 85.71%, specificity 82.75%, positive predictive value was 54.54% and negative predictive value was 96% with biopsy as the reference standard. The sensitivity and specificity of cytology in this study were 90% and 47.36%, respectively with a positive predictive value of 47.36% and negative predictive value of 90%.
Conclusion: VIA and VILI are quick, simple, inexpensive and low technology test. Both when combined have high sensitivity as well as specificity. Thus, can be easily practiced by clinicians and paramedics. Also immediate results can help in early diagnosis and prompt treatment during the same visit. Through VIA and VILI a large number of population that go undetected can be screened at an affordable cost with higher sensitivity and specificity.
Aim of the Study: (I)The aim of the study is to compare the efficacy of VIA and VILI with PAP smear cytology in screening for cancer cervix, premalignant and malignant lesions of cervix so that VIA/VILI can be used in peripheral areas where cytology is not available. (II)Early detection and tretmeant of pre cancerous conditions before they progress to invasive cancer.
Methodology: This clinical study was conducted on 200 gynaecological patients who presented to Sree Mookambika Institute of Medical Sciences hospital satisfying the inclusion and exclusion criteria.
Results: In the present study,the sensitivity of VIA and VILI was 85.71%, specificity 82.75%, positive predictive value was 54.54% and negative predictive value was 96% with biopsy as the reference standard. The sensitivity and specificity of cytology in this study were 90% and 47.36%, respectively with a positive predictive value of 47.36% and negative predictive value of 90%.
Conclusion: VIA and VILI are quick, simple, inexpensive and low technology test. Both when combined have high sensitivity as well as specificity. Thus, can be easily practiced by clinicians and paramedics. Also immediate results can help in early diagnosis and prompt treatment during the same visit. Through VIA and VILI a large number of population that go undetected can be screened at an affordable cost with higher sensitivity and specificity.
Biography
Mounika Kuppili is 28 years old, completed her bachelors in Medicine and Bachelors in Surgery from India, currently doing her junior residency in Masters Of Surgery- Obstetrics and Gynaecology at Sree Mookambika Institute Of Medical Sciences, Kanyakumari, Tamilnadu, India. She has over 3 publications and has presented poster at state/national conference. She is an active member among the student wing in the Obstetrics and Gynaecology societies in India.
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