Visual inspection more effective in detecting lesions: Study

Visual inspection with acetic acid can emerge as a cost-effective alternative screening method for cervical lesions as compared to expensive and complicated tests like pap smears, a new study shows.

The recently published study by Sir Ganga Ram hospital suggests that visual inspection with acetic acid (VIA) can be an effective screening modality in low resource settings, specially in developing countries like India, where the expertise for definitive tests is not available in rural and semi-urban areas.

The study finds that VIA, in comparison to a pap smear test, is not only easy to use but also easy to interpret and reliable with quick results.

As compared to this, the pap smear is laboratory based, expensive, requires expertise and therefore may not be available everywhere. The results of VIA are available immediately whereas for pap smear, it requires a follow up visit.

The cross-sectional study was conducted on 500 women by researchers from the hospital's department of obstetrics and gynaecology.

The study which was approved by the institutional review board and ethics committee was conducted in the out patient department of the hospital.

Cancer of the uterine cervix is a leading cancer in India. In different regions of the country, the highest risks among women were observed in breast cancer followed by cervical cancer and gall bladder cancer with a cumulative risk of one woman in 35, one in 61 and one woman in 123 likely to develop the cancer in their lifetime.

Geeta Mediratta, author of the study and senior consultant in the department of obstetrics and gynaecology at the hospital, said: "Our findings suggest that VIA with a high sensitivity is comparable to pap smear and can be used as an alternate screening test especially in low resource settings where the expertise for definitive tests is not available."

Neha Puri, co-author of the study, said: "VIA is a simple outpatient (OPD) procedure, inexpensive and results are available immediately. The 'screen and refer' approach for further testing can be used."

The VIA test is not only simple to perform but is also very cost effective. The cost of VIA is Rs. 200 to screen 100 patients whereas pap smear test on the same number of patients costs Rs. 20,000.