Comparison of Visual Inspection with Acetic Acid and Pap Smear in Detecting Premalignant Lesions of Cervix
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2019, Vol 6, Issue 11
Abstract
Background: Worldwide cervical cancer comprises approximately 12% of all cancers in women with 122,844 new cases reported annually in India. Cervical cancer progresses slowly for a decade as it is preceded by intraepithelial histological changes, visual inspection aided by acetic acid test (VIA), Pap smear, and colposcopy can be utilized as a tool for cytological analysis of cervix, early identification of risk factors and preinvasive lesions of cervix and hence early diagnosis and treatment of cervical cancer even in rural areas. Objectives: The objectives are as follows: (1) To compare VIA with Pap smear in detecting premalignant lesions of cervix, (2) to correlate VIA and Pap smear findings with colposcopic findings, and (3) to localize the lesion by colposcopy and obtain biopsy wherever necessary. Materials and Methods: A prospective study of 200 women attending the Gynecology Outpatient Department at BLDE (deemed to be university) Shri B. M. Patil Medical College Hospital and Research Center, Vijayapura, between October 2016 and August 2018 was included in the study. Results: The incidence of premalignant and malignant lesions of the cervix was 7%. Cervical cytology was normal in 16%, inflammatory in 77.5%, ASCUS in 4%, LSIL in 1.5%, HSIL in 0.5%, and squamous cell carcinoma in 0.5%. XII Maximum number of patients with ASCUS and LSIL was in the age group of 35–39 years and 40–44 years and HSIL and squamous cell carcinoma occurred in the age group of 25–29 years and 30–34 years, respectively. ASCUS, LSIL, and HSIL were seen in parity 3–5 and malignancy in parity >3 observed mostly in low socioeconomic status. All abnormal Pap smears mainly presented with white discharge PV, pain abdomen and with irregular PV bleeding as the second most common and erosion and cervicitis as the most common clinical picture. Cervical biopsy confirmed HSIL and invasive carcinoma cytology. Conclusion: In India, cytology, a low cost and easily accessible test, is the most logical screening modality although it has very low sensitivity, detection rates could be further improved using liquid-based cytology and the use of endocervical cytobrush.
Authors and Affiliations
Nikita P. Naidu, Purushottam B. Jaju
Keywords
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