Effectiveness of pap smear via colposcopy and screening potential in premalignant lesions of the cervix

Cervical cancer is a significant public health concern, especially in developing countries, where approximately 80% of cases are diagnosed. Despite being a preventable disease, it remains widespread. In India, cervical cancer constituted 9.4% of all cancer cases and 18.3% of new cancer cases in 2020. However, cervical cancer is now considered preventable through screening and curable, especially when detected early, highlighting the importance of prevention.

A new study aimed to identify abnormal cervical appearances indicative of carcinoma. The study enrolled 329 women attending the OPD clinic at the Integral Institute Of Medical Sciences and Research hospital over 18 months. With their consent, the participants underwent VIA, Pap smear, and colposcopy tests.

The results showed that 18.5% of the cases were VIA-positive, while 81.5% were VIA-negative. Among the VIA-positive cases, 77% of the Pap smears were abnormal, with various abnormalities identified. Of note, among the VIA-negative cases, all Pap smears were normal. Colposcopies were performed on 61 participants, and among the VIA-positive cases, 73.6% were positive for cervical intraepithelial neoplasia (CIN) or other abnormalities. Biopsies were conducted on all colposcopy patients, revealing various findings, including CIN I, chronic cervicitis, squamous cell carcinoma, and adenocarcinoma in situ. 

In conclusion, VIA offers a promising alternative to cytology for detecting precancerous cervical lesions due to its cost-effectiveness, immediate results, and high sensitivity and specificity. In resource-limited settings like India, VIA is particularly valuable as it allows for prompt counseling and referral for treatment, reducing delays in diagnosis and treatment.

Source: Khan M F F, Gupta B, Srivastava M, Lata K, Singh V, Twinkle. Indian J Obstet Gynecol Res 2023;10(3):247-253