Diagnostic Accuracy of Visual Inspection with Acetic Acid (VIA) and Conventional Pap Smear in Detecting Cervical Intraepithelial Neoplasia (CIN) in Women of Reproductive Age at a Tertiary Care Hospital

Background: Cervical cancer, the second leading cause of cancer-related morbidity and mortality among women globally, requires timely diagnosis at its precancerous stage to reduce disease severity and mortality rates. Histopathology, though the gold standard for diagnosis, is invasive and costly. This study aimed to assess the diagnostic accuracy of two less invasive procedures, i.e., Visual Inspection with Acetic Acid (VIA) and Pap smear against histopathology, to identify the most accurate early cervical cancer detection method. Objective: To compare the diagnostic accuracy of Visual Inspection with Acetic Acid (VIA) and Pap smear for detecting cervical lesions, using histopathology as a gold standard. Study Design: A cross-sectional study Duration and Setting: Arif Memorial Teaching Hospital, Lahore, from January 2024 to September 2024. Methods: This study was conducted with 290 women of reproductive age. Following cervical visualization and inspection, Pap smears and VIA tests were performed. Positive findings on VIA and Pap smear prompted biopsy. Sensitivity, specificity, positive and negative predictive values, and the overall accuracy of VIA and Pap smear were calculated relative to histopathology results. Results: The study included women with a mean age of 35.18 ± 8.29 years. VIA showed sensitivity, specificity, PPV, NPV, and accuracy of 91.86%, 95.59%, 89.77%, 96.53%, and 94.48%, respectively, while the Pap smear exhibited values of 83.72%, 94.61%, 86.75%, 93.24%, and 91.38%, respectively. Conclusion: VIA demonstrated higher diagnostic accuracy than the Pap smear in detecting cervical malignancy, suggesting it as a cost-effective, non-invasive option for early screening in resource-limited settings.