Colposcopic Findings of Cervix in Visual Inspection of the Cervix After Acetic Acid Application (VIA) Positive Cases Attending Colposcopic Clinic at Chittagong Medical College Hospital (CMCH)

Abstract

Background: Colposcopy is an essential diagnostic tool used to evaluate abnormalities of the cervix, particularly after a positive Visual Inspection with Acetic Acid (VIA) areas of dysplasia or neoplasia, which may appear white (acetowhite) after application. Objectives: The aim of the study was to evaluate the role of VIA technique in the early detection of carcinoma. Methods: Diluted acetic acid (3-5%) was applied to the cervix during routine gynaecological examination. Women with positive result were referred for colposcopy. Women with both positive and negative results found in colposcopic examination underwent colposcopy guided biopsy. Then both sensitivity and specificity of colposcopy was determined and the result was compared with other studies of home and abroad. Statistical analyses of the results were be obtained by using window-based Microsoft Excel and Statistical Packages for Social Sciences (SPSS-24). Results: A prospective study was conducted from July 2007 to June 2008 on 100 women attending at the "Colposcopy Clinic" of CMCH, Chittagong. Only VIA positive cases were taken into consideration of the study. Colposcopy evaluated 62 cases as CIN (CINI 31 %, CIN II-17%, CIN-III 14%) and 3.0% as invasive lesions. Biopsy evaluated 36% as CIN (CIN 1- 17%, CIN- II 10%, CIN-III 9%) and 1% as invasive lesions. The sensitivity and specificity of colposcopy were 81.08% and 44.44% respectively. Conclusion: VIA is an important method in low resource settings and it is simple and easy to perform. Colposcopy is an indispensable procedure in the evaluation of unhealthy cervix though it requires considerable training and experience. It has got high sensitivity and negative predictive value.