Document Detail

Are Papanicolaou smears enough? Acetic acid washes of the cervix as adjunctive therapy: a HARNET study. Harrisburg Area Research Network.
MedLine Citation:
PMID:  1517723     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Papanicolaou smear has a false-negative rate ranging from 10% to 50%. Adjunctive screening methods for detecting cervical disease are thus of interest. We studied an adjunctive acetic acid wash of the cervix to detect additional cases of cervical disease not found by the Papanicolaou smear. METHODS: All women attending six family practice offices for health maintenance during the period August 1989 through April 1990 were examined (N = 2827). Papanicolaou smears were obtained using a Cytobrush and wooden spatula. Each subject's cervix was also visually examined 1 minute after application of 5% acetic acid. Women with abnormal Papanicolaou smear results or abnormal acetowhite areas on visual inspection of the cervix underwent colposcopy. RESULTS: Ninety-three cases of biopsy-proven condyloma or cervical intraepithelial neoplasia (CIN) were found on the basis of abnormal Papanicolaou smear results alone, 33 on the basis of abnormal acetic acid wash results alone, and 14 on the basis of abnormal results from both a Papanicolaou smear and an acetic acid wash. The prevalence of CIN was 3%. The overall positive predictive value for abnormal results obtained by acetic acid wash was .55 (95% CI = .43 to .63). CONCLUSIONS: Using a 1-minute 5% acetic acid wash improves the detection of cervical disease by 30%. Consideration should be given to augmenting the Papanicolaou smear with this safe, simple, and effective technique on premenopausal women during regular health maintenance examinations.
D C Slawson; J H Bennett; J M Herman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of family practice     Volume:  35     ISSN:  0094-3509     ISO Abbreviation:  J Fam Pract     Publication Date:  1992 Sep 
Date Detail:
Created Date:  1992-10-07     Completed Date:  1992-10-07     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7502590     Medline TA:  J Fam Pract     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  271-7     Citation Subset:  AIM; IM    
Department of Family Practice, Harrisburg Hospital, PA.
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MeSH Terms
Acetic Acid
Acetic Acids / diagnostic use*
Condylomata Acuminata / diagnosis
Evaluation Studies as Topic
Middle Aged
Uterine Cervical Dysplasia / diagnosis
Uterine Cervical Neoplasms / diagnosis*
Vaginal Smears*
Reg. No./Substance:
0/Acetic Acids; 64-19-7/Acetic Acid

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