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Int J Gynaecol Obstet. 2010 Jun;109(3):230-4. doi: 10.1016/j.ijgo.2010.01.019. Epub 2010 Mar 29.

Cervical cancer screening with naked-eye visual inspection in Colombia.

Author information

1
Subdireccion Investigaciones y Salud Pública, Instituto Nacional de Cancerología de Colombia, Bogotá, Colombia. rmurillo@cancer.gov.co

Abstract

OBJECTIVE:

To assess the accuracy of visual inspection provided by nurses through combining acetic acid (VIA) and Lugol's iodine (VILI) in a low-resource region of Colombia.

METHODS:

A cross-sectional study with 4957 women was conducted to evaluate visual inspection techniques as the basis for see-and-treat approaches in cervical cancer control. All women underwent conventional cytology, VIA performed by nurses, and a combination of VIA and VILI. All women underwent colposcopy and biopsies were obtained for any positive test.

RESULTS:

A total of 762 women underwent biopsy, 4945 women were included in the analysis of conventional cytology, and 4957 were included in the analysis of VIA and VIA-VILI. Positivity rates were 1.3% and 4.3% for HSIL and LSIL cytology, 7.4% for VIA, and 10.1% for VIA-VILI. Sensitivity for cytology was 52.9% and 36.8% for LSIL and HSIL thresholds, 53.6% for VIA, and 68.1% for VIA-VILI. The corresponding specificity was 95.0%, 99.2%, 93.2%, and 90.8% respectively. The parallel combination of VIA-VILI and cytology LSIL-threshold revealed the best performance as a screening strategy.

CONCLUSION:

The use of VIA-VILI simulating colposcopic procedures and provided by nurses represents a good alternative for implementing see-and-treat programs in Latin America. Program constraints should be taken into account.

PMID:
20347442
DOI:
10.1016/j.ijgo.2010.01.019
[Indexed for MEDLINE]

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