Can Revised Visual Inspection with Acetic Acid (VIA) Test Improve the Performance of Crude VIA Test of in Low-Resource-Setting Countries?

Purpose: To compare the performance of our suggested “revised VIA” test to the traditional crude VIA test. Methods: A cross-sectional study was conducted in the early cancer detection unit. During the period from June 2014 to January 2016, 500 patients were included in our study. After clinical assessment, VIA test was performed followed by applying the five criteria of the revised test at the same time. All cases were referred to colposcopy for confirmation. Cervical punch biopsy was performed for cases with positive colposcopic findings. Results: The prevalence of CIN in this study was 11/500 (2.2%). The positive cases with crude VIA test were 236 of 500 screened women (47%). Its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy (100, 53.98, 4.66, 100, and 55%, respectively). When we applied the five criteria of our suggested “revised VIA” test, only 175 cases (35%) were positive. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy became 100, 66.46, 6.28, 100, and 67%, respectively. Conclusion: The suggested “revised VIA” test improved the performance of the crude VIA test by improving its specificity. We recommend further studies to evaluate its performance.