Effectiveness of Visual Inspection With Acetic Acid in the Detection of Cervical Neoplasia Intraepithelial

Friday, 28 July 2017

Nancy Griselda Pérez Briones, MSN
Kerena Hernandez, MSN
Raul Adrian Castillo-Vargas, MSN
Mireya del Carmen González Álvarez, PhD
Alejandra Muñoz Morales, PhD
Abigahil Valdés Rivera, BSN
School of Nursing, Universidad Autónoma de Coahuila, Saltillo, Coahuila, Mexico

Introduction:

In Mexico every two hours a woman dies of Cervical Cancer, it`s the second leading cause of death from malignancies, and it is estimated that about 4, 000 deaths occur every year. Currently to reduce the impact of the disease there are several tests for the early detection and timely treatment, the most used is the Cervical Cytology (CC), however it is not a definitive diagnostic method alone, a more efficient and effective strategy is the screening by Visual Inspection with Acetic Acid (VIA) at 5%, as it is a simple test, accessible and reliable, with immediate results regarding the probable existence of a precancerous lesion test.

Purpose:

Determine the effectiveness of VIA as a screening test compared to the CC in Cervical Intraepithelial Neoplasia Detection(CIN).

Methods:

The study population consisted of 74 women between 15 and 49 years attending outpatient clinic at a rural hospital in the city of Ramos Arizpe, Coahuila. CC underwent colposcopy and simultaneously. The sampling was performed using CC Ayre spatula and endocervical brush. Colposcopy was performed using acetic acid solution at 5% then with Lugol solution. In patients who were positive for either test, underwent biopsy of the lesion.

Results:

VIA has greater sensitivity in detecting CIN as 74 women, 36 were found positive, compared with only 5 positive results by CC. It is noteworthy that high specificity was found because of the 36 biopsies were ratified 34 dysplastic lesions, including one patient with Cancer in Situ result.

Conclusion:

Los resultados obtenidos en este estudio confirman, el alto número de falsos negativos de la CC en comparación con los del IVAA. Con ello, se concluye que la IVAA es adecuada para ser utilizada como alternativa a la CC, ya que así la paciente obtendrá un diagnostico temprano y tratamiento oportuno.

The results obtained in this study confirm the high number of false negative CC had compared with VIA. With this, we conclude that VIA is suitable for use as an alternative to CC, as this patient get an early diagnosis and timely treatment.

Bibliografía

  • Arbyn M. et al. (2012). Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine, 30 (5): 88-99.
  • De Vuyst H. et al. (2012). Prevalence and determinants of human papillomavirus infection and cervical lesions in HIV-positive women in Kenya. British Journal of Cancer, 107 (9): 1624-1630.
  • Cortiñas P., Ríos K., & Sánchez J. (2008). Citologia cervical como pesquisa: factores para mejorar la sensibilidad. Gac. Méd. Caracas, 116 (1): 37-40.
  • Joshi S. et al. (2013). Screening of cervical neoplasia in HIV-infected women in India. AIDS, 27 (4): 607-615.
  • León J. (2008). Cerviscopia una alternativa para mejorar el diagnóstico de lesiones cervicales premalignas. Rev. Científica Colposcopia, 1 (1): 11-13.
  • López A. & Lizcano M. (2006). Cáncer Cervicouterino y el virus del papiloma humano: la historia que no termina. Cancerología, 1: 31-55.
  • Organización Mundial de la Salud (OMS) & Organización Panamericana de la Salud (OPS) (2014). Directrices de la OPS/OMS sobre tamizaje y tratamiento de las lesiones precancerosas para la prevención del cáncer Cervicouterino. ISBN: 978-92-75-31833-1.
  • Sherris J. et al. (2010). Enfoques para el tamizaje alternativo del cáncer cervical. Perspectivas Internacionales en Salud Sexual y Reproducción. No. Esp.: 31-38.