Enhancing Cervical Cancer Screening VIA vs. Colposcopy; A prospective study

Background: Cervical cancer is a significant cause of morbidity and mortality globally, particularly in low-resource settings. Visual inspection with acetic acid (VIA) and colposcopy are two widely used methods for cervical cancer screening, but their comparative effectiveness in settings like Bangladesh remains unclear. Objective: This prospective observational study compares the diagnostic accuracy and feasibility of VIA versus colposcopy for cervical cancer screening among women attending the Department of Obs & Gyne at Peerless Diagnostic & Hospital, Naogaon, Bangladesh. Method: A total of 220 women aged 16-55 years, representing various age groups and educational levels, were recruited from January 2021 to December 2023. Participants underwent both VIA and colposcopy examinations, with findings compared against histopathological results from biopsies, when indicated. Sensitivity, specificity, positive predictive value, and negative predictive value of VIA and colposcopy were analyzed. Result: Preliminary results show VIA with a sensitivity of 75% and specificity of 80%, with 40% of participants showing abnormalities, of which 30% were confirmed as true positives. Colposcopy exhibited superior performance, with a sensitivity of 85% and specificity of 90%. Abnormalities were detected in 50% of cases, with 45% confirmed as true positives. Colposcopy resulted in fewer false positives (10%) compared to VIA (20%), indicating its higher diagnostic accuracy. Histopathological confirmation revealed a higher proportion of true positives with colposcopy compared to VIA in women with abnormal findings. Conclusions: Colposcopy exhibits superior sensitivity and specificity compared to VIA in cervical cancer screening among Bangladeshi women.