Myanmar Health Sciences Research Journal


Archives   2015

Myanmar   Health   Sciences   Research   Journal

Volume   27,  Number   2

TITLE:   Visual Inspection with Acetic Acid (VIA) in Detection of High Grade Squamous Intraepithelial Lesion (HSIL) and Cancer of Cervix in Community Setting
AUTHOR:   Thazin Nyunt, Yin Yin Soe, Mar Mar Aye & Hla Hla Win
SOURCE:   Myanmar Health Sciences Research Journal. 2015; 27(2): 88-93
ABSTRACT:   Cervical cancer, an important public health issue, is the most common cancer among the women in developing countries. The aim of this study was to determine the role of visual inspection with acetic acid (VIA) in detection of high-grade squamous intraepithelial lesion (HSIL) and cancer of cervix in community setting. A cross-sectional, community-based study was conducted in 1012 ever married women aged 25-64 years in South Okkalapa Township, Yangon, Myanmar. Both Pap smear and VIA were done. Biopsy was taken from all VIA-positive patients and colposcopy was done in abnormal Pap smear patients and colposcopic directed biopsy was taken. Histology was regarded as the gold standard for diagnosis. Out of total 1012 study population, 54 women (5.34%) were VIA-positive and 53 women (5.2%) had abnormal Pap results. The positive predictive value (PPV) of VIA and Pap smear were 38.89% and 50.94%, respectively. Among the participants with abnormal histology results, VIA could detect 8 out of the 9 women (89%) for HSIL and two out of the 2 women (100%) with cervical cancer. The estimated prevalence of squamous intraepithelial lesion (SIL) was 2.67%, of which HSIL and cervical cancer represented 0.89% and 0.20% in this study. Regarding agreement between VIA and Pap smear, K value (kappa agreement) was 0.4. Therefore, the results of VIA were comparable to that of Pap smear. In resource poor setting, where cyto-pathological service is limited, VIA warrants consideration as an alternative to Pap smear in the detection of HSIL and invasive cervical carcinoma.
SUBJECT HEADINGS:   VIA, HSIL, Cervical screening, Community
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