The study of diagnostic value of pap smear comparing with visual inspection of cervix after acetic acid application in detecting premalignant lesions of cervix

Background: Objective of the study was to compare the effectiveness of VIA and pap smear for screening of premalignant lesions of cervix and to compare the performance of VIA used alone and combined with pap smear for screening of premalignant lesions of cervix. Methods: VIA and Pap smear were performed in 260 patients attending routine gynaecology OPD. Positive cases of either or both screening tests were subjected to colposcopy and biopsy if indicated. The reports of histopathology were correlated with the pap smear and VIA findings and thereby sensitivity, specificity, positive and negative predictive values of each of the screening methods were calculated and results were analysed. Results: 260 patients were screened for premalignant lesions of cervix by VIA and pap smear both, 37 of 260 patients, (14.2%) were VIA positive, 30 of 260 patients (11.5%) were pap smear positive, 20 of 260 patients (7.69%) were positive for VIA as well as pap smear, 25 of 260 patients (9.6%) were confirmed of premalignant lesions on histopathology, 24 patients were diagnosed CIN and one patient was diagnosed with CIS. Conclusions: VIA has lower sensitivity and specificity compared to Pap smear but the results are comparable. Both the tests are fairly accurate. A combination of VIA and Pap smear increased the sensitivity and specificity to 100%.