A population-based study of visual inspection with acetic acid (VIA) for cervical screening in rural Nigeria

Int J Gynecol Cancer. 2013 Mar;23(3):507-12. doi: 10.1097/IGC.0b013e318280f395.

Abstract

Objective: Cervical cancer is the most common gynecological cancer in developing countries. Visual inspection with acetic acid (VIA) was introduced to screen for cervical premalignant lesions in developing countries owing to the inability of many countries to implement high-quality cytologic services. We sought to compare VIA performance among different health workers in Nigeria.

Methods: In a population-based project, 7 health workers who had been screening women with VIA for approximately 2 years at local government health centers in rural Nigeria were retrained in a 2-week program using the International Agency for Research on Cancer training manual. Women from a rural village who had never had cervical cancer screening were recruited into the study. Each woman had cervical cancer screening by VIA, liquid-based cytologic test, and oncogenic human papillomavirus (HPV) DNA test.

Results: Despite similar participant characteristics, across all age groups, providers had wide ranges of VIA results; 0% to 21% suspect cancer and 0% to 25% were VIA positive. Visual inspection with acetic acid was insensitive compared to a combination of cytologic and HPV tests.

Conclusion: In our study, VIA was not reproducible, nor was it sensitive compared to cytologic and HPV tests.

Publication types

  • Comparative Study

MeSH terms

  • Acetic Acid*
  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / epidemiology
  • Adenocarcinoma / virology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / virology
  • Cervical Intraepithelial Neoplasia / diagnosis*
  • Cervical Intraepithelial Neoplasia / epidemiology
  • Cervical Intraepithelial Neoplasia / virology
  • Early Detection of Cancer
  • Female
  • Follow-Up Studies
  • Humans
  • Mass Screening*
  • Middle Aged
  • Neoplasm Staging
  • Nigeria / epidemiology
  • Papillomaviridae / genetics
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / virology
  • Prevalence
  • Prognosis
  • Risk Factors
  • Rural Population
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / virology
  • Young Adult

Substances

  • Acetic Acid