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Effect of Cervicitis on Visual Inspection With Acetic Acid

Davis-Dao, Carol A. MS1; Cremer, Miriam MD, MPH2; Felix, Juan MD3; Cortessis, Victoria K. PhD1

Journal of Lower Genital Tract Disease:
doi: 10.1097/LGT.0b013e31816d1da4
Original Articles
Abstract

Objective. The objective of this study was to determine whether the presence of cervicitis influenced the accuracy of visual inspection with acetic acid (VIA).

Materials and Methods. In a pilot study, 502 women from rural El Salvador were screened for cervical cancer using methods including colposcopy and VIA. The presence of cervicitis was assessed by grading the amount of inflammation on each woman's cervical biopsy. Data from 495 women found to be free of cervical neoplasia were analyzed for the present study.

Results. In this study population, 74% of women were classified as having cervicitis. Both the result of visual inspection and the result of colposcopy were highly associated with the presence of cervicitis (p =.007 and p =.006, respectively). Women with cervicitis were twice as likely to have a positive VIA result as women without cervicitis (odds ratio = 2.0, 95% CI: 1.0-3.7).

Conclusions. The presence of cervicitis may influence the accuracy of results obtained from colposcopy and VIA. This observation may be of particular importance in low-resource settings such as El Salvador where visual inspection methods are more commonly used in screening for cervical cancer.

In Brief

The presence of cervicitis may lead to a high rate of false positives from visual inspection with acetic acid (VIA).

Author Information

1Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, CA, 2Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, and 3Department of Pathology, Women's and Children's Hospital, University of Southern California, Keck School of Medicine, Los Angeles, CA

Reprint requests to: Miriam Cremer, MD, MPH, Department of Obstetrics and Gynecology, New York University School of Medicine, 550 1st Avenue, NBV 9E2, New York, NY 10016. E-mail: mlcremer@hotmail.com

This study was conducted in El Salvador.

©2008The American Society for Colposcopy and Cervical Pathology