The role of low-level magnification in visual inspection with acetic acid for the early detection of cervical neoplasia

Rengaswamy Sankaranarayanan, Surendranath Srinivas Shastri, Parthasarathi Basu, Cédric Mahé, Ranajit Mandal, Geethanjali Amin, Chinmayi Roy, Richard Muwonge, Smriti Goswami, Pradip Das, Roshini Chinoy, Lucien Frappart, Sharmila Patil, Devjani Choudhury, Titha Mukherjee, Ketayun Dinshaw

Research output: Contribution to journalArticle

47 Scopus citations

Abstract

Several studies have investigated the accuracy of naked eye visual inspection with acetic acid (VIA) in the early detection of cervical neoplasia. It is not clear whether low-level (2-4×) magnification (VIAM) can improve the sensitivity and specificity of VIA. The accuracy of both VIA and VIAM, provided by independent health workers, were evaluated in three cross-sectional studies involving 18,675 women aged 25-65 years in Kolkata and Mumbai in India. All screened women were investigated with colposcopy and biopsies were obtained based on colposcopy findings. The final disease status was based on the reference standard of histology (if biopsies had been taken) or colposcopy. Data from the studies were pooled to calculate the test characteristics for the detection of high-grade squamous intraepithelial lesions (HSIL). 14.1% and 14.2% were positive on testing with VIA and VIAM respectively. Two hundred twenty-nine were diagnosed with HSIL and 68 with invasive cancer. The pooled sensitivity, specificity, positive and negative predictive values for VIA in detecting high-grade squamous intraepithelial lesions (HSIL) were 60.3% (95% CI: 53.6-66.7), 86.8% (95% CI: 86.3-87.3), 5.9% (95% CI: 5.0-7.0), and 99.4% (95% CI: 99.2-99.5), respectively. The values were 64.2% (95% CI: 57.6-70.4), 86.8% (95% CI: 86.2-87.3), 6.3% (95% CI: 5.3-7.3) and 99.4% (95% CI: 99.3-99.6), respectively, for VIAM. Low-level magnification did not improve the test performance of naked eye visualization of acetic acid impregnated uterine cervix.

Original languageEnglish (US)
Pages (from-to)345-351
Number of pages7
JournalCancer detection and prevention
Volume28
Issue number5
DOIs
StatePublished - Nov 19 2004

Keywords

  • Cervical cancer
  • Developing countries
  • Early detection
  • Magnified visual inspection with acetic acid
  • Prevention
  • Screening
  • VIA
  • VIAM
  • Visual inspection with acetic acid

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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  • Cite this

    Sankaranarayanan, R., Shastri, S. S., Basu, P., Mahé, C., Mandal, R., Amin, G., Roy, C., Muwonge, R., Goswami, S., Das, P., Chinoy, R., Frappart, L., Patil, S., Choudhury, D., Mukherjee, T., & Dinshaw, K. (2004). The role of low-level magnification in visual inspection with acetic acid for the early detection of cervical neoplasia. Cancer detection and prevention, 28(5), 345-351. https://doi.org/10.1016/j.cdp.2004.04.004