Publication:

A comparative study to see the effectiveness of Pap smear, visual inspection with 3-5% acetic acid and its confirmation by cervical biopsy

Background Cancer of the cervix is a leading cause of morbidity and mortality among women worldwide. The present study was undertaken to compare the effectiveness of Pap smear and visual inspection with 3-5% acetic acid (VIA) in screening carcinoma cervix followed by its confirmation by cervical biopsy.

Methods A total of 100 patients with abnormal looking cervices or symptomatic patients having age beyond 30 years, attending the obstetrics and gynaecology OPD at Naval Hospital Powai, Mumbai from 31st December 2015 to 31st December 2017 were selected for the study. Pap smear and VIA was done on consecutive days. In positive cases cervical biopsy were done to confirm the result.

Results The sensitivity of VIA was 100% but at the same time specificity was 41% there will be unnecessary investigation and biopsy in false positive cases. The sensitivity of cytology was 75% and specificity was 97%. Not a single case was missed by Pap smear only one case of severe dysplasia on cytology had squamous cell carcinoma on HPE which was done after 90 days because of delay in patients follow up.

Conclusions Both the Pap smears and VIA is very effective screening tool for cervical cancer and histopathological examination remains the mainstay. But VIA is very cost effective and easy procedure, though it gives false positive reports but is not going to miss any case, rather leads to over diagnosis of the cases with cervicitis and hence treatment starts early and thus the progress of disease can be slowed down or even stopped.