Cervical cancer screening with naked-eye visual inspection in Colombia

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


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.

MeSH terms

  • Acetic Acid
  • Adult
  • Biopsy
  • Colombia
  • Colposcopy
  • Cross-Sectional Studies
  • Female
  • Humans
  • Iodides
  • Mass Screening / methods*
  • Middle Aged
  • Nurses / organization & administration*
  • Physical Examination
  • Sensitivity and Specificity
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / pathology


  • Iodides
  • Acetic Acid
  • Lugol's solution