Evaluating Visual Inspection with Acetic Acid and Human Papilloma Virus Tests for Cervical Cancer Screening in Ndola District, Zambia: A Focus on Positive Predictive Value

Background: Visual Inspection with Acetic Acid (VIA) and Human Papilloma virus (HPV) tests are crucial methods for early detection of premalignant lesions, especially in resource-limited environment.No study has been conducted on the accuracy of VIA and HPV tests in detecting premalignant cervical lesions in Ndola district.This study explored the effectiveness of VIA and HPV tests in detecting premalignant cervical lesions in Ndola district, focusing on their Positive Predictive Value (PPV) as a crucial factor in evaluating their clinical utility. Methods and Materials:A prospective cross-sectional study selected 172 female participants, with 49 testing positive for both VIA and HPV using purposeful sampling.The study recruited women aged 18 years or old who attended cervical cancer clinic at Ndola Teaching Hospital from January 2024 to November 2024, had loop electrosurgical excision procedure (LEEP) done and histopathology results obtained.They all voluntarily consented to participate in the study.Using SPSS version 20 software, descriptive statistics were performed.Positive predictive values and their confidence intervals for both VIA and HPV tests in detecting premalignant were evaluated and recorded in both frequencies and percentages. Results:The positive predictive values for premalignancy/malignant lesions in positive VIA and HPV tests were 58.1% (mean = 1.42, 95% CI: 1.34 -1.49) and 71.1% (mean =1.29, 95% CI: 1.15 -1.42) respectively. Conclusion and Recommendation:HPV has high PPV than VIA in Ndola district.To minimize false positives in detecting cervical lesions, national policymakers should scale up HPV test as primary screening test while VIA test should be reserved for identifying lesion margins during LEEP provision.