Comparison of visual inspection with acetic acid (via) with papanicolaou (pap) smear method of cervical cancer screening among women attending a tertiary hospital in Lafia, north central Nigeria

Abstract

Background: Cervical cancer is the second most common killer disease of women in the world, and the commonest killer of women in developing countries like Nigeria, with about 86% of the disease occurring in those countries. There is therefore the need to improve on the current screening measures for the disease.

Method: This hospital based descriptive cross sectional study involved women aged 21 to 65 years who attended the GOPC of Dalhatu Araf Specialist Hospital Lafia either as patients or patient relatives during the study period. A simple random sampling technique was used to recruit 239 participants. Data collected about the participants included socio-demographic background, gynaecologic and other  relevant medical histories, and the presence of risk factors for cervical cancer. Physical examination included the weight, height, BMI and blood pressure of the study participants. All women enrolled in the study underwent both VIA and Pap smear tests. The chi square test was used to determine significance of associations between groups. Student's t-test was used to compare means of results as appropriate. A P-value less than 0.05 was considered significant. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for VIA using Pap smear as the reference standard.

Results: Only 28 (11.7%) of the study participants had heard about cervical cancer. None of them had ever heard about VIA while 10 (4.2%) had heard about Pap smear test as a screening test for cervical cancer. Fifty four (22.6%) of the 239  participants had VIA positive results while 33 (13.8%) of the study participants had Pap smear positive results. Eleven (4.6%) of the participants had inconclusive Pap smear results. The sensitivity of VIA was 66.7%, the specificity, positive predictive value and negative predictive value were 84.5%, 40.7% and 94.1% respectively. VIA results were available immediately whereas Pap smear results took four to eight weeks to obtain. VIA procedure was also much cheaper than Pap smear.

Conclusion: This study revealed that the level of awareness about cervical cancer among the study participants was low. No participant was aware of VIA as a  screening method for cervical cancer but a small percentage of the participants were aware of Pap smear test. VIA was much cheaper to carry out than Pap smear and it took less time to obtain results. VIA is a reliable alternative to Pap smear test as a screening test for cervical cancer