Comparative Study of Cervical Pap Smear and Visual Inspection of The Cervix To Detect Premalignant Disease of The Cervix

Abstract = 72 times | PDF = 19 times

Main Article Content

Rozhan Yassin Khalil Khanda Abdolrahman Qader

Abstract

The goal of current study is to compare visual inspection method of the cervix by using acetic acid sensitivity, specificity, positive and negative predictive values with Pap smear test values. This cross sectional study was obtained in Sulaimani city Kurdistan region at Maternity Teaching Hospital throughout the period (first September 2012) to (first February 2001). This study include 115 samples were reproductive women and premenopausal  between ages 20-50 years old with symptomatic women ( vaginal discharge, dyspareunia, post coital bleeding , intermenestrual bleeding ) and prepared patients for a Pap smear test done for them. The cervix was painted with 5% concentration of acetic fluid for visual inspection method and monitored for aceto-white wounds and biopsies were taken from suspected areas. After that, the samples in 95% concentration of the ethyl alcohol were fixed. The results shows that, 114 samples among all other samples were appropriate  for analyzing, statistical data analyzed by Epi Info software program and Chi-squared test used to find significance between variables with considering P-value less or lower than 0.05 as significant level. The result indicate that sensitivity rate was 16% for visual inspection method, specificity 71%, positive predictive value 3.13% and negative predictive value 93.9% to detect pre-cancerous lesion of the cervix. In conclusion, cervix visual inspection method for cancer had a low rate sensitivity compare with pap smear with a non-significant relationship between the two methods and Pap smear needed to conform visual inspection for cervical cancer.

Keywords

Keywords: Pap smear, Premalignant disease of cervix, visual inspection, acetic acid, cervical cancer.

Downloads

Download data is not yet available.

Article Details

References

[1] J. Ferlay, I. Soerjomataram, R. Dikshit, S. Eser, C. Mathers, M. Rebelo, et al., "Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012," International journal of cancer, vol. 136, pp. E359-E386, 2015.
[2] S. Rebecca, N. Deepa, and J. Ahmedin, "Cancer statistics, 2012," Ca Cancer J Clin, vol. 62, pp. 10-29, 2012.
[3] D. Saslow, D. Solomon, H. W. Lawson, M. Killackey, S. L. Kulasingam, J. Cain, et al., "American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer," CA: a cancer journal for clinicians, vol. 62, pp. 147-172, 2012.
[4] S. Albert, O. Oguntayo, and M. Samaila, "Comparative study of visual inspection of the cervix using acetic acid (VIA) and Papanicolaou (Pap) smears for cervical cancer screening," Ecancermedicalscience, vol. 6, 2012.
[5] J. M. Walboomers, M. V. Jacobs, M. M. Manos, F. X. Bosch, J. A. Kummer, K. V. Shah, et al., "Human papillomavirus is a necessary cause of invasive cervical cancer worldwide," The Journal of pathology, vol. 189, pp. 12-19, 1999.
[6] W. Small Jr, M. A. Bacon, A. Bajaj, L. T. Chuang, B. J. Fisher, M. M. Harkenrider, et al., "Cervical cancer: a global health crisis," Cancer, vol. 123, pp. 2404-2412, 2017.
[7] A. B. Miller and W. H. Organization, "Cervical cancer screening programmes: managerial guidelines," 1992.
[8] P. A. Cohen, A. Jhingran, A. Oaknin, and L. Denny, "Cervical cancer," The Lancet, vol. 393, pp. 169-182, 2019.
[9] E. Shepard, "George Papanicolaou: development of the Pap smear," Medical Center Archives of New York-Presbyterian/Weill Cornell, vol. 2015, 2011.
[10] B. Zahid, N. Khawaja, and R. Tayyeb, "Prevalence of abnormal cervical cytology and its relation with age and parity," Annals of King Edward Medical University, vol. 11, 2005.
[11] R. Sankaranarayanan, R. Wesley, S. Thara, N. Dhakad, B. Chandralekha, P. Sebastian, et al., "Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol's iodine (VILI) in cervical cancer screening in Kerala, India," International Journal of Cancer, vol. 106, pp. 404-408, 2003.
[12] A. Bhattacharyya, J. Nath, and H. Deka, "Comparative study between pap smear and visual inspection with acetic acid (via) in screening of CIN and early cervical cancer," Journal of Mid-life Health, vol. 6, pp. 53-58, April 1, 2015 2015.
[13] M. Peiretti, I. Zapardiel, V. Zanagnolo, F. Landoni, C. P. Morrow, and A. Maggioni, "Management of recurrent cervical cancer: A review of the literature," Surgical Oncology, vol. 21, pp. e59-e66, 2012/06/01/ 2012.
[14] S. Khan, R. Jha, and P. R. Pant, "Accuracy of cytology, visual inspection with acetic acid or lugol’s iodine in cervical cancer screening," Nepal Journal of Obstetrics and Gynaecology, vol. 2, pp. 48-53, 2007.
[15] L. Denny, "The prevention of cervical cancer in developing countries," BJOG: An International Journal of Obstetrics & Gynaecology, vol. 112, pp. 1204-1212, 2005.
[16] R. FOTRA, S. GUPTA, and S. GUPTA, "Sociodemographic Risk Factors for Cervical Cancer in Jammu Region of Jand K State of India First Ever Report From Jammu," cancer, vol. 6, p. 8, 2014.
[17] K. Singh and S. More, "Visual inspection of cervix with acetic acid in early diagnosis of cervical intraepithelial neoplasia and early cancer cervix," J Obstet Gynaecol India, vol. 60, pp. 55-60, 2010.
[18] A. Goel, G. Gandhi, S. Batra, S. Bhambhani, V. Zutshi, and P. Sachdeva, "Visual inspection of the cervix with acetic acid for cervical intraepithelial lesions," International Journal of Gynecology & Obstetrics, vol. 88, pp. 25-30, 2005.
[19] J. Jeronimo, O. Morales, J. Horna, J. Pariona, J. Manrique, J. Rubiños, et al., "Visual inspection with acetic acid for cervical cancer screening outside of low-resource settings," Revista panamericana de salud pública, vol. 17, pp. 1-5, 2005.
[20] F. Lim, "Management of premalignant lesions of the cervix," ANNALS-ACADEMY OF MEDICINE SINGAPORE, vol. 31, pp. 357-365, 2002.
[21] L. Gaffikin, P. Blumenthal, J. McGrath, and Z. Chirenje, "Visual inspection with acetic acid for cervical-cancer screening: Test qualities in a primary care setting," The Lancet, vol. 353, p. 869, 1999.
[22] E. Megevand, L. Denny, K. Dehaeck, R. Soeters, and B. Bloch, "Acetic acid visualization of the cervix: an alternative to cytologic screening," Obstetrics & Gynecology, vol. 88, pp. 383-386, 1996.
[23] S. Cecchini, R. Bonardi, A. Mazzotta, G. Grazzini, A. Iossa, and S. Ciatto, "Testing cervicography and cervicoscopy as screening tests for cervical cancer," Tumori Journal, vol. 79, pp. 22-25, 1993.
[24] S. Bomfim, E. Santana‐Franco, and L. Bahamondes, "Visual inspection with acetic acid for cervical cancer detection," International Journal of Gynecology & Obstetrics, vol. 88, pp. 65-66, 2005.