TY - JOUR
T1 - The role of low-level magnification in visual inspection with acetic acid for the early detection of cervical neoplasia
AU - Sankaranarayanan, Rengaswamy
AU - Shastri, Surendra S.
AU - Basu, Parthasarathi
AU - Mahé, Cédric
AU - Mandal, Ranajit
AU - Amin, Geethanjali
AU - Roy, Chinmayi
AU - Muwonge, Richard
AU - Goswami, Smriti
AU - Das, Pradip
AU - Chinoy, Roshini
AU - Frappart, Lucien
AU - Patil, Sharmila
AU - Choudhury, Devjani
AU - Mukherjee, Titha
AU - Dinshaw, Ketayun
PY - 2004
Y1 - 2004
N2 - 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.
AB - 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.
KW - Cervical cancer
KW - Developing countries
KW - Early detection
KW - Magnified visual inspection with acetic acid
KW - Prevention
KW - Screening
KW - VIA
KW - VIAM
KW - Visual inspection with acetic acid
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U2 - 10.1016/j.cdp.2004.04.004
DO - 10.1016/j.cdp.2004.04.004
M3 - Article
C2 - 15542259
AN - SCOPUS:20844444591
SN - 0361-090X
VL - 28
SP - 345
EP - 351
JO - Cancer Detection and Prevention
JF - Cancer Detection and Prevention
IS - 5
ER -