Accuracy of Visual Tests for Primary Cervical Cancer Screening in Rural Nepal

Journal of Nepal Medical Association

article

Niresh Thapa¹  Muna Maharjan³  Girishma Shrestha⁴  Narayani Maharjan⁵  Deborah Lindell⁶  Na Zuo¹  Jing Yang¹  Ninu Maskey⁷  Hongbing Cai¹ 

[1]Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors

[2]Karnali Academy of Health Sciences

[3]HOPE School of Nursing, Zhongnan Hospital of Wuhan University

[4]Department of Pathology, Patan Hospital, Patan Academy of Health Sciences

[5]Department of Clinical Laboratory Science, Zhongnan Hospital of Wuhan University

[6]Frances Payne Bolton School of Nursing, Case Western Reserve University

[7]Department of Haemato-Pathology, Zhongnan Hospital of Wuhan University

关键词: accuracy;    cervical cancer;    cytology;    screening;    visual tests;   

DOI  :  10.31729/jnma.3857

学科分类：社会科学、人文和艺术（综合）

来源: Nepal Medical Association since

【 摘 要 】

Introduction: In Nepal, cervical cancer is the most common female cancer. Unfortunately, there is no uniform effective screening system available all around the country. The objective of this study is to evaluate the cytology, Visual Inspection with Acetic Acid and with Lugol’s Iodine alone or in combination to detect a pre-cancerous lesion in rural Nepal.Methods: It is an analytical cross-sectional study. Convenience sampling technique was used to select participants who were apparently healthy, married, non- pregnant women of aged 20-65 years for cervical cancer screening program. Screening tests were performed on all eligible women (n=2143) after socio-demographic and reproductive health data collection. A biopsy was applied as a gold standard test. Cross-tabulations were used to describe the test sensitivity, specificity, positive predictive value, and negative predictive value at a 95% confidence interval. Diagnostic odds ratio was also calculated. Results: A majority, 2143 (94%), of women accepted and participated in this study. The sensitivity vs specificity of cytology, VIA, and VILI was 57.1% vs 98.3%, 71.4% vs 88.8% and 78.6% vs 85.1%, and of the co-testing of ‘Both positive VIA and VILI’ and ‘Either positive VIA or VILI’ was 64.3% vs 85.7% and 90.1% vs 83.7% respectively. Negative predictive value of all tests exceeded 99.7%. Cytology had the highest Diagnostic odds ratio (64.9), followed by the co-test ‘Either positive VIA or VILI’ (27.7).Conclusions: Cervical cancer screening by co-testing ‘Either positive VIA or VILI’ is more useful than cytology; VIA and or VILI are easy, safe, feasible and well-accepted tests in a low resource setting, Nepal.

【 授权许可】

CC BY