Efficacy and Acceptability of Thermal Ablation in Patients with Positive Documented Visual Inspection with Acetic Acid (Do-VIA) Results

Siti Azizah,1– 3 Gatot Purwoto,1,2 Laila Nuranna,1,2 Tricia Dewi Anggraeni,1,2 Tofan Widya Utami,1,2 Fahrina Fahrunnisa,2 Najmarani Devi Firdaus2 1Faculty of Medicine, University of Indonesia, Depok, Jawa Barat, Indonesia; 2Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Cipto Mangunkusumo National Referral Hospital, Jakarta, Indonesia; 3Gynecologic Oncology Division, Department of Obstetrics and Gynecology, Universitas Indonesia Hospital, Depok, Jawa Barat, IndonesiaCorrespondence: Siti Azizah, Email [email protected]: This study aimed to evaluate the efficacy and acceptability of thermal ablation (TA) as a treatment modality in patients with positive Documented Visual Inspection with Acetic Acid (Do-VIA) results, in a low-resource clinical setting.Methods: A retrospective cohort study was conducted at the VIA clinic of Cipto Mangunkusumo National Referral Hospital (RSCM), Jakarta, Indonesia, from January to July 2024. Patients with positive VIA-DoVIA results were treated with thermal ablation therapy (also known as cold coagulation) and followed up for three months to assess clinical outcomes and acceptability.Results: Out of 99 patients who underwent VIA screening, 47 tested positive. Of these, 35 received thermal ablation therapy. Three months post-treatment, 25 patients tested negative on VIA, while only 3 patients remained VIA-positive. Patient-reported side effects included clear vaginal discharge (52%), vaginal discharge with blood spots (3%), itchy discharge (38%), and short-term vaginal spotting (7%). No severe adverse events were reported.Conclusion: Thermal ablation therapy appears to be an effective and well-tolerated alternative to cryotherapy for the treatment of cervical precancerous lesions. It demonstrates good efficacy, minimal side effects, and high acceptability among healthcare providers in low-resource settings.Keywords: cervical cancer, cold coagulation, Do-VIA, precancerous lesion