Abstract

Objective: To find out different grades of cervical intraepithelial lesions of cervix with visual inspection of cervix with acetic acid (VIA). Methods: VIA was carried out in 540 eligible women attending Gynaecology Outpatient Department for gynecological problems. The women underwent a complete clinical evaluation. All screened women (540) were evaluated by colposcopy and biopsies which were taken from different quadrants of the cervix. The final diagnosis was based on histology, which allowed direct estimation of sensitivity, specificity, and predictive values of VIA and colposcopy. Those with abnormal lesions diagnosed by histology were considered as true positive. Results: Out of 540 patients screened, 212 (39.27%) were VIA positive. More patients with cervical lesions were detected by VIA than colposcopy. There were 63 (11.67%) women with histologic cervical intraepithelial neoplasia (CIN I), which was found in 150 (27.78%) by VIA and 138 (25.56%) by colposcopy. VIA and colposcopy yielded high grade CIN II in the same number of patients. Biopsy proven cancer was found in 24 (4.45%) which was detected in 18 (3.33%) by VIA and colposcopy. Sensitivity and specificity of VIA were 68.50% and 70.45% respectively. Positive predictive value was 41.04% and negative predictive value was 90.85%. Conclusions: VIA can differentiate a normal cervix from a precancerous cervix with reasonable accuracy. The sensitivity and specificity of VIA are comparable to the other studies. So VIA may reduce the cervical intraepithelial lesions both in urban and rural areas.

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