Early detection of cervical cancer by visual inspection: A population-based study in rural India
✍ Scribed by B.M. Nene; S. Deshpande; Kasturi Jayant; Atul Madhukar Budukh; P.S. Dale; D.A. Deshpande; Aruna S. Chiwate; Sylla G. Malvi; S. Deokar; D. Maxwell Parkin; Rengaswamy Sankaranarayanan
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- French
- Weight
- 443 KB
- Volume
- 68
- Category
- Article
- ISSN
- 0020-7136
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✦ Synopsis
A total of 3784 women aged 35 and above living in 26 villages in rural Maharashtra state, India, were invited to undergo a pelvic examination, to evaluate the performance of unaided visual inspection by trained paramedical workers in detecting cervical cancer. Of this number, 2 I35 (56.4%) women complied with the invitation. Paramedical workers scored I120 (57.3%) and I I 8 (6%) women as having abnormal cervices using the lowand high-threshold criteria respectively. There was good agreement between the visual findings of the paramedical workers and those of a gynaecologist. All subjects had a cervical smear. A total of 10 cervical cancers were detected by cytology/ histology. The sensitivity of visual inspection by paramedical workers to detect cervical cancer was 90.0% using the low threshold and 60.0% with the high threshold to define a positive test. The values for specificity were 42.8% and 94.5Oh respectively. The results obtained by the gynaecologist were very similar. Cost savings implied by limiting cytology/other investigations to approximately half of the population pre-selected on the basis of visual inspection are likely to be offset by the necessity to repeat the test at frequent intervals, repeated follow-u visits and other investigations.