DIAGNOSTIC ACCURACY OF VISUAL INSPECTION WITH ACETIC ACID AND PAPANICOLAOU (PAP) SMEAR FOR CERVICAL CANCER SCREENING, TAKING HISTOPATHOLOGY AS GOLD STANDARD

Abstract

Objective: To compare the diagnostic accuracy of VIA and PAP smear for cervical cancer screening, taking histopathology as the gold standard.

Design: This was a cross-sectional study.

Place & Duration of the study: The study was conducted at Obstetrics and Gynecology Department of Sahiwal Teaching Hospital, Sahiwal from May 2025 to September 2025.

Methodology: The study was involving 132 women aged 20-60 years. Participants underwent VIA and PAP smear tests, followed by biopsy for histopathology. Diagnostic performance was evaluated based on sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.

Results: VIA demonstrated higher sensitivity (85.5%) and diagnostic accuracy (87.5%) compared to PAP smear, which showed a sensitivity of 78.0% and diagnostic accuracy of 85.0%. However, PAP smear had higher specificity (92.3%) than VIA (88.4%). Both tests had comparable PPV, with VIA at 61.5% and PAP smear at 71.0%, while VIA had a higher NPV (96.2%) compared to PAP smear (94.1%).

Conclusion: Both VIA and PAP smear are effective for cervical cancer screening. VIA offers higher sensitivity, making it more suitable for resource-limited settings, while PAP smear is more specific. The choice between the two methods should depend on available resources, with VIA being a valuable tool in low-resource settings.