Usefulness of cytology and visual inspection with acetic acid in the detection of neoplastic lesions of the cervix at the Centro Médico Oncomujer during 2013-2014. Lima, Peru
DOI:
https://doi.org/10.24265/horizmed.2017.v17n4.03Keywords:
Cancer, Papanicolaou, Cervical intraepithelial neoplasiaAbstract
Objective: To determine the usefulness of cytology and visual inspection with acetic acid in the detection of neoplastic lesions of the cervix. Materials and methods: An observational, retrospective, descriptive and cross-sectional study. A population of female patients who attended the Centro Médico Oncomujer between 2013 and 2014 for a cervical cancer screening with Pap test and VIA was evaluated. Women referred for biopsy and with a positive result in one or both tests (Pap-VIA) were included in the study. Results: The mean age was 41.66 years old (range: 20-50 years). One thousand one hundred eight (1108) patients were evaluated with Pap smear and VIA: 8.2% (92/1108) of the patients evaluated by Pap smear had a positive result and 27.6% (306/1108) of those evaluated by VIA tested positive. The results of the cytology (Pap smear) against the biopsy showed a sensitivity of 30.6% (95% CI: 23.7%-3.48%), specificity of 88.4% (95% CI: 77.89.7%-94.51%), positive predictive value of 85.9% (95% CI: 73.65%-999.48%) and negative predictive value of 35.4% (95% CI: 28.43%-43.16%). The results of VIA against the biopsy showed a sensitivity of 99.3% (95% CI: 96.04%-99.97%), specificity of 5.8% (95% CI: 1.87%-14.93%), positive predictive value of 70.9% (95% CI: 64.49%-76.74%) and negative predictive value of 80% (95% CI: 29.88%-98.953.16%). Conclusions: The high false-positive rate of VIA can lead to overtreatment, regardless of the advantages of its use, especially in remote and low-income populations.
Downloads
References
World Health Organization. Cancer Fact Sheets: Cervical Cancer. Estimated incidence, Nortality and Prevalence Worlwide in . 2012.
Organización Panamericana de la Salud. Cáncer Cervicouterino. 2014
Solidoro A, Olivares L. Cáncer del cuello uterino en el Perú: Impacto económico del cáncer invasor. Portal Ginecología Perú. 2010.
Instituto Nacional de Enfermedades Neoplásicas. Registro de Cáncer de Lima Metropolitana: Volumen IV Estudio de incidencia y mortalidad (2004-2005).Instituto Nacional del Cáncer. Estadísticas. 2014
Sasieni P, Adams J. Effect of screening on cervical cancer mortality in England and Wales: analysis of trends with an age period cohort model. Bmj. 1999; 318 (7193): 1244-5.
Almonte M, Murillo R, Sánchez G, Jerónimo J, Salmerón J, Ferreccio C, et al.Nuevos paradigmas y desafíos en la prevención y control del cáncer de cuello uterino en América latina. Salud publica Méx. 2010; 52(6):544-59
International Agency for Research on Cancer (IARC).Globocan 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. 2012
Hakama-Louhivvori k. A screming program me for cervical cancer that worked. Cancer Surv 1988; 7 (3): 403-16.
Arbyn M, Reboloj M, De Kok I, Fender M, Becker N, Oankeilly M, et al. The challenges of organising cervical screning programmes in the 15 old member states of the Europea Union. Eurj. Cancer. 2009; 45 (15): 2671-8.
Jeronimo J, Morales O, Horna J, Pariona J, Manrique J, Rubiños J, et al. La inspección visual con ácido acético para el tamizaje del cáncer cervicouterino donde no hay escasez de recursos Rev Panam Salud Publica. 2005; 17(1); 1-5
Terrazas S, Ibáñez C, Lagos M, Poggi H, Brañes J, Barriga M, et al . Examen de detección de virus papiloma humano en el tamizaje de cáncer cervicouterino en un Servicio de Salud de Santiago, Chile. Rev. Méd. Chile. 2015; 143( 1 ): 56-62.
Luciani S, Winkler J. Prevención del cáncer cervicouterino en el Perú: lecciones aprendidas del proyecto demostrativo tamizaje y tratamiento inmediato (TATI) de las lesiones cervicouterinas. Washington: PAHO; 200629. Norma Técnico- Oncológica para la prevención, detección y manejo de las lesiones premalignas del cuello uterino a nivel nacional. Lima, Mayo 2008.
ASCUS-LSIL Triage Study (ALTS) Group. Results of a randomized trial on the management of cytology interpretations of atypical squamous cells of undetermined significance. Am J Obstet Gynecol. 2003;188(6):1383
Published
How to Cite
Issue
Section
License
Copyright (c) 2017 Horizonte Médico (Lima)

This work is licensed under a Creative Commons Attribution 4.0 International License.
Horizonte Médico (Lima) (Horiz. Med.) journal’s research outputs are published free of charge and are freely available to download under the open access model, aimed at disseminating works and experiences developed in biomedical and public health areas, both nationally and internationally, and promoting research in the different fields of human medicine. All manuscripts accepted and published in the journal are distributed free of charge under the terms of a Creative Commons license – Attribution 4.0 International (CC BY 4.0).