Visual inspection with acetic acid and cytology as screening methods for cervical lesions in Cameroon.

Objective: To assess the accuracy of visual inspection with acetic acid (VIA) as a screening method for cervical lesions.

Methods: VIA and cytological smears were carried out on the cervices of non-pregnant women aged 30-60 years with no previous history of cervical cancer. Cervices with aceto white lesions or positive Pap smears, and one in ten negative cervices (control), were biopsied.

Results: 5010 women were enrolled, 4813 (96.1%) were screened. 4767 (99.%) had adequate cytology smears. 574 (11.9%) had colposcopy. 1743 biopsies were obtained of which 528 were controls. The sensitivity of VIA was 70.4% versus 47.7% for Pap smear. VIA specificity was 77.6% versus 94.2% for Pap smear; PPV for VIA was 44.0% versus 67.2% for Pap smear; and NPV for VIA was 91.3% versus 87.8% for Pap smear.

Conclusions: VIA has acceptable test qualities and may in low resource settings be implemented as a large scale screening method.