Faculty Collaboration Database

Adequacy of visual inspection with acetic acid in women of advancing age. Int J Gynaecol Obstet 2011 Apr;113(1):68-71

Date

01/29/2011

Pubmed ID

21272884

DOI

10.1016/j.ijgo.2010.10.018

Scopus ID

2-s2.0-79952987422 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

OBJECTIVE: The present study assessed the adequacy and predictive performance of visual inspection with acetic acid (VIA) in women over the age of 50 years and compared the specificity and sensitivity of VIA with that of the conventional cytology.

METHODS: In total, 588 Salvadoran women ages 50-79 underwent VIA, Pap smear, and cervical biopsy. VIA was considered adequate if the squamocolumnar junction was completely visible. A positive biopsy was defined as cervical intraepithelial neoplasia (CIN) 2 or worse.

RESULTS: Age was negatively correlated with VIA adequacy (P=0.04). Nevertheless, the majority of women-even in the older age groups-had adequate examinations. The adequacy of VIA was positively correlated with gravida (P=0.01) and was higher in women who had been treated by cryotherapy (P=0.02). The rate of positive biopsies was unexpectedly low (n=6 [1%]) making it difficult to assess the predictive performance of VIA. In this small sample, the sensitivities of VIA (17%) and Pap (33%) were low; the high number of false negatives could not be fully explained by inadequacy of the examinations.

CONCLUSIONS: Adequacy of VIA declined with age. However, the squamocolumnar junction was visible to the naked eye in the majority of women, indicating that they are good candidates for VIA.

Author List

Cremer M, Conlisk E, Maza M, Bullard K, Peralta E, Siedhoff M, Alonzo T, Felix J

Author

Juan Felix MD Vice Chair, Director, Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acetic Acid
Age Factors
Aged
Cryotherapy
El Salvador
False Negative Reactions
Female
Humans
Mass Screening
Middle Aged
Papanicolaou Test
Physical Examination
Predictive Value of Tests
Sensitivity and Specificity
Uterine Cervical Dysplasia
Uterine Cervical Neoplasms
Vaginal Smears