Dr. (Mrs.) Rajshri Kumari, Dr. (Mrs.) Kumudini Jha, Dr. Debarshi Jana


Background: The cervix is the commonest site of female genital tract cancer worldwide. Cancer cervix has a long pre-invasive stage, giving an
opportunity for its early detection and treatment.
Methods: The present study conducted on 500 patients in OPD and Indoor admitted patients during the period of October 2017 to September 2019.
Pap's smears were studied and reported according to the Bethesda classification. On next visit patient attended with cytology report and VIA, VILI
was performed and then subjected to colposcopy.
Results: In this study, 500 symptomatic patients attending OPD were analysed. Of these, 76 patients were VILI positive, 46 patients were Pap
smear positive and 60 patients were colposcopy positive. Those patients who were positive for any of these three tests; VILI, Pap smear, or
colposcopy, underwent cervical biopsy to confirm diagnosis of CIN or early carcinoma. Punch biopsies were taken in 79 patients in whom 52
patients were biopsies positive. Adenocarcinoma was confirmed by conebiopsy in one patient. This patient was Pap smear positive, but colposcopy
and VILI, negative. Pie chart (1) shows that 447 patients were normal. Abnormal findings were noted in 53 patients; 34 cases were positive for
CIN I (6.8%), 9 cases CIN II (1.8%), and 6 cases CIN III (1.2%). Malignancy was found in 4 patients (0.8%).
Conclusions: In low resource settings, screening for carcinoma cervix by Pap smear can be replaced by cheaper and easily available visual method
like VILI, which has the higher sensitivity to detect any grade of dysplasia, with a reasonable specificity. Even when screening with Pap smear is
available, it should be combined with visual screening methods like VILI, as many cases of CINI are missed by Pap smear may be picked up by
visual test and combined testing will reduce the false negative cases. In remote areas VILI should be used as a primary screening tool.


Cancer cervix, Colposcopy, VIA

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