Abstract
Carcinoma of the cervix is the most common cancer in Thai women. Over 40 years,
Pap smears have been used as the standard technique for cervical cancer screening, but
the coverage is quite low among the population and the incidence of advanced stage
cancer is still high. Acetic acid (VIA) testing had been introduced as an alternative method
in order to improve the effectiveness of cervical cancer screening in Thailand. When the
VIA result was positive, the client is referred for further management, but most doctors
do a repeat Pap smear to start rescreening as usual. This study was conducted to evaluate
the effectiveness of VIA and determine how necessary it is to practice in VIA-positive women.
This retrospective descriptive study was conducted in VIA-positive women who
were sent for colposcopic examination between February 17, 2004 and February 16, 2007,
a total of 109 cases. Pap smear and colposcopic cervical biopsy, with or without LEEP
conization, were performed. A Pap smear result of “normal” meant normal; inflammation
was found in 102 cases. “Abnornal” meant SIL or CIN to carcinomas, which was
found in seven cases. The histopathological result was classified as “normal”, meaning
negative and cervicitis, and “abnormal” meaning CIN I to carcinomas, which were found
in 90 and 19 cases respectively. Pap smear sensitivity was 36.84 percent, specificity was
100 percent, positive predictive value was 100 percent, and negative predictive value was
88.24 percent. This study suggested that repeated screening by Pap smear in VIA-positive
women should not be recommended due to its low sensitivity.
