Comparison of direct visual inspection (DVI) with pap smear in diagnosis of precancerous lesion of cervix

Mallah, F and Nazari, F and Navali, N and Hajipour, B (2012) Comparison of direct visual inspection (DVI) with pap smear in diagnosis of precancerous lesion of cervix. Life Science Journal, 9 (4). pp. 2556-2560.

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Abstract

The aim of this study was to compare direct visual inspection (DVI) with Pap smear in diagnosis of precancerous lesion of cervix. A total of 1500 women were screened cytologically as well as clinically with direct visual inspection of cervix after application of acetic acid (DVI). A total of 1500 women were screened cytologically as well as clinically with direct visual inspection of cervix after application of acetic acid (DVI). Women with abnormal findings in either Pap smear or DVI were investigated with colposcopy and biopsies were obtained from colposcopically assessed abnormal lesions. Seven women had abnormal Pap smear (6 ASCUS, 1 CIN1) with colposcopy and biopsies. 3 of 7 were actually positive. All of 3 positive tests were positive in DVI but one of the 4 false- positive tests was positive in DVI. Nine women had abnormal DVI which colposcopy and biopsies confirmed 8 of them as premalignant or malignant lesions of cervix. Two of them were invasive cancer (negative Pap smears), 3 CIN1 (one of them negative in Pap smear, one CIN1, one ASCUS), 2 CIN2 (one of them negative in Pap smear, one ASCUS) and 1 CIN3 (negative Pap smear). Test efficiency parameters particularly sensitivity, specificity, and positive predictive values of DVI were 88.8%, 99.9% and 88.8%, respectively; those of Pap smear were 37.5%, 99.06%, 42.85%, respectively. Direct visual inspection (DVI) is feasible and easy to perform with superior sensitivity and specificity to Pap smear in detecting cervical premalignant and malignant lesions. Direct visual inspection can be used as an efficient primary screening tool with a satisfactory low biopsy rate in low resources settings

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