Cervical screening by visual inspection with acetic acid, India.
Article Type: Brief article
Subject: Acetic acid (Health aspects)
Acetic acid (Research)
Cervical cancer (Prevention)
Medical screening (Methods)
Medical screening (Usage)
Pub Date: 11/01/2008
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2008 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: Nov, 2008 Source Volume: 16 Source Issue: 32
Topic: Event Code: 310 Science & research
Product: Product Code: 2868402 Acetic Acid NAICS Code: 325199 All Other Basic Organic Chemical Manufacturing SIC Code: 2869 Industrial organic chemicals, not elsewhere classified
Geographic: Geographic Scope: India Geographic Code: 9INDI India
Accession Number: 192393444
Full Text: In a cluster randomised controlled trial in India, 31,000 healthy women aged 30-59 years were screened using visual inspection with acetic acid (VIA) during 2000-2003, and 31,000 women received standard care. Researchers found a 25% reduction in cervical cancer incidence and a 35% reduction in mortality in the intervention group compared with the control group over the period 2000-2006. The 10% of the intervention group who screened positive were given colposcopy, directed biopsies and, where appropriate, cryotherapy, during the screening visit. Correlation with histology for quality showed that 27% of these were treated unnecessarily, an acceptably high level. VIA appears to be a simple, feasible and effective method of cervical screening in low-resource settings. However, high quality training of providers, continuous quality control, and monitoring are required. A high coverage rate is not easy to achieve, demonstrated by this study's participation rate of 64% in the intervention group, despite a prior education programme. However, VIA may be the way forward in the near future in developing countries with no current screening programme. (1,2)

(1.) Sankaranarayanan R, Esmy PO, Rajkumar R, et al. Effect of visual screening on cervical cancer incidence and mortality in Tamil Nadu, India : a cluster-randomised trial. Lancet 2007;370: 398-406.

(2.) Szarewski A. Cervical screening by visual inspection with acetic acid. Lancet 2007;370:365-66.
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