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)

  • Dr. Dilruba Yasmin Senior Consultant, Department of Obstetrics & Gynaecology, District Sadar Hospital, Sherpur, Bangladesh
  • Dr. Tamanna Rahman Junior Consultant, Department of Obstetrics & Gynaecology, Dhaka Medical College & Hospital, Dhaka, Bangladesh.
  • Dr. Marufa Khatun Medical Officer, Department of Obstetrics & Gynaecology Upazila Health Complex, Mithapukur, Rangpur, Bangladesh.
  • Dr. Raffat Sultana Medical officer, Department of Obstetrics & Gynaecology, Sheikh hasina national Institute of burn plastic surgery, Dhaka, Bangladesh.
  • Dr. Rawshan Ara Sultana Consultant, Department of Obstetrics & Gynaecology, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Keywords: Colposcopy, Abnormalities, Car-cervix, VIA, Acetic Acid

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.

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References

Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, Bray F. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. The Lancet Global Health. 2020 Feb 1;8(2): e191-203.

Arbyn M, Castellsagué X, de Sanjosé S, Bruni L, Saraiya M, Bray F, Ferlay J. Worldwide burden of cervical cancer in 2008. Annals of oncology. 2011 Dec 1;22(12):2675-86.

Simoens C, Martin‐Hirsch PP. Prophylactic vaccination against human papillomaviruses to prevent cervical cancer and its precursors. Cochrane database of systematic reviews. 2018(5).

Mohakhali D. Knowledge about Risk Factors of Carcinoma Cervix among the Women Attending for VIA Test in a Selected Hospital.

Nessa AS, Chowdhury SB, Fatima PA, Kamal MO, Sharif MO, Azad AK. Cervical cancer screening program in Bangladesh. Bangladesh Journal of Obstetrics & Gynaecology. 2018;33(1):63-73.

Canfell K, Kim JJ, Brisson M, Keane A, Simms KT, Caruana M, Burger EA, Martin D, Nguyen DT, Bénard É, Sy S. Mortality impact of achieving WHO cervical cancer elimination targets: a comparative modelling analysis in 78 low-income and lower-middle-income countries. The Lancet. 2020 Feb 22;395(10224):591-603.

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2024 May;74(3):229-63.

Saxena U, Sauvaget C, Sankaranarayanan R. Evidence-based screening, early diagnosis and treatment strategy of cervical cancer for national policy in low-resource countries: example of India. Asian Pac J Cancer Prev. 2012 Jan 1;13(4):1699-703.

Parkin DM, Bray FI, Devesa S. Cancer burden in the year 2000. The global picture. European journal of cancer. 2001 Sep 1; 37:4-66.

Cronje HS. Screening for cervical cancer in developing countries. International Journal of Gynecology & Obstetrics. 2004 Feb 1;84(2):101-8.

Jahan Y. Colposcopic findings of VIA positive gynaecological cases of BSMMU (Doctoral dissertation, Dissertation submitted to BCPS).

Krishnegowda S, Veena MS. Efficacy of colposcopy technique with Pap smear and histology in screening of cervical lesions. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2014 Sep 1;3(3):696-703.

Datta AK. Essentials of human anatomy. Current books international; 2017 Oct 17.

Mvundura M, Tsu V. Estimating the costs of cervical cancer screening in high-burden Sub-Saharan African countries. International Journal of Gynecology & Obstetrics. 2014 Aug 1;126(2):151-5.

CITATION
DOI: 10.26838/MEDRECH.2024.11.6.741
Published: 2024-11-16
How to Cite
1.
Dr. Dilruba Yasmin, Dr. Tamanna Rahman, Dr. Marufa Khatun, Dr. Raffat Sultana, Dr. Rawshan Ara Sultana. 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). Med. res. chronicles [Internet]. 2024Nov.16 [cited 2024Dec.4];11(6):256-64. Available from: https://medrech.com/index.php/medrech/article/view/730
Section
Original Research Article