Reasons for Variation in Sensitivity and Specificity of Visual Inspection with Acetic Acid (VIA) for the Detection of Pre-Cancer and Cancer Lesions of Uterine Cervix


Alternative strategies such as visual inspection of cervix with acetic acid, are real time, economical and easilyimplemented methods for cervical cancer screening. However, variable sensitivity and specificity have beenobserved in various community based studies. The possible reasons could include variation in man power training,light source used for visualization, and preparation of diluted (4-5%) acetic acid and its storage. A standardizedprotocol for training, teaching material (easy to understand in the local language) for trainees, supervision andreinforcement by intermittent and supplementary training to check the quality of their observation, a standardprotocol for preparation dilute acetic acid and its storage and a standard good light source (equivalent to daylight) are needed to minimize the variation in sensitivity and specificity of VIA in community settings.