Clinical Significance of Positive Visual Inspection with Acetic Acid (VIA) Result at Nakornping Hospital
Abstract
Abstract
Background: Cervical cancer screening using visual inspection with acetic acid (VIA) program has been done in Chiang Mai Province since 2003. There were some patients referred to Nakornping Hospital because of certain clinical indications for referral. However, there was no previous data collection about the final diagnosis of these patients before.
Objective: To know the final diagnosis and prevalence rate of cervical squamous intraepithelial lesion (SIL) and cancer in patients with positive VIA results being referred to Nakornping Hospital.
Materials and method: All positive VIA patients whom referred to Nakornping Hospital during 1st July 2005 to 30th June 2006 received colposcopic examination. If abnormal colposcopic finding was found, colposcopic directed biopsy would be done to get the final tissue diagnosis. During this study period, all necessary data had been prospectively recorded on colposcopic data form. These data were retrospectively collected and analyzed in this study.
Design: Retrospective descriptive study
Setting: Nakornping Hospital, Chiang Mai, Thailand
Result: Among 142 patients, who had positive VIA results and were referred, the major reason of referral was large acetowhite lesion on cervix. All patients underwent colposcopy, 100 had abnormal colposcopic findings. In this group, final diagnosis was confirmed by colposcopic directed biopsy, twenty patients (14.1%) had low-grade squamous intraepithelial lesions, sixteen patients (11.3%) had high-grade squamous intraepithelial lesions, three patients (2.1%) had invasive cancer, forty-four patients (31%) had chronic cervicitis, eight patients (5.6%) had atypical immature squamous metaplasia and intraepithelial lesion cannot be excluded, nine patients (6.3%) were normal.
Conclusion: Patients with positive VIA result must be examined by colposcopy. Colposcopic directed biopsy should be done in case of abnormal colposcopic finding, because low-grade and high-grade squamous intraepithelial lesions were found in 25.4% while invasive cervical cancer was found in 2.1%.
