To compare the effectiveness of pap smear, via and colposcopy for screening of premalignant lesions of cervix

Authors : Mahin Fatima Faridi Khan, Bhavana Gupta, Meenakshi Srivastava, Kusum Lata, Vibha Singh, Twinkle

DOI : 10.18231/j.ijogr.2023.052

Volume : 10

Issue : 3

Year : 2023

Page No : 247-253

Background: Cervical cancer poses a major public health challenge, particularly in developing nations, where around 80% of cases are diagnosed. Despite being a preventable disease, it remains highly prevalent, with over 600,000 new cases and 340,000 deaths reported worldwide in 2020. According to the GLOBOCAN 2020 data, cervical cancer represented 9.4% of all cancer cases and 18.3% of new cancer cases in India. However cervical cancer is now considered preventable through cervical screening and curable, particularly if detected early, which emphasizes the importance of "prevention is better than cure". The current research utilized Pap smear, VIA, and colposcopy to identify abnormal cervical appearances indicative of carcinoma.
Materials and Methods: During a span of 18 months, a study was carried out on 329 women who were attending the OPD clinic at Integral Institute Of Medical Sciences and Research hospital. With the participants' consent, the women underwent VIA, Pap smear and colposcopy tests as part of the study.
Results: In the study 61 (18.5%) cases were found positive in VIA findings and 268 (81.5%) were VIA negative. In this study 85.7% of Pap smears were normal, out of 18.5% VIA positive, 77% of pap smears were abnormal 23 (37.5%) ASC (NOS/US), 8 (13.1%) AGC and AGC NOS, 6 (9.1%) AEC, 5 (8.2%) LSIL, 5 (8.2%) HSIL and out of 268 VIA negative all Pap were normal (100%). 61 colposcopies were done, out of 18.5% VIA positive, 73.6% colposcopies were positive 29 were CIN I (47.5%), 10 were CIN III (16.3), 6 were CIN II (9.8%) and 13.2% were normal and 13.2% were cervicitis. Biopsy was done in all colposcopy patients, 49.2% were CIN I, 27% were chronic cervicitis, 10% were CIN I, 3.2% were squamous cell carcinoma and 1.6% were adenocarcinoma in situ and 1.6% were cx show no atypia.
Conclusion: VIA offers a promising alternative to cytology for detecting premalignant lesions of the uterine cervix, with its cost-effectiveness, on-the-spot results, and high sensitivity and specificity. In low-resource settings like India, where a substantial number of women lack access to screening tests, VIA is especially well-suited. This screening method allows for immediate counseling and referral for treatment, helping to reduce delays in diagnosis and treatment which can help to minimize delays in diagnosis and treatment.


Keywords: Colposcopy, PAP smear, Malignant lesions.


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