Comparison between pap smear and visual inspection with lugol's iodine (VILI) in screening of cervical intraepithelial neoplasia (CIN) and early cancer cervix
Jyan Dip Nath, Ashish Kumar Bhattacharjee, Harajyoti Deka
Objectives: To screen the patient at Gynaecology Out Patient Department (GOPD) in the age group 18-60 yrs by doing pap smear, VILI (Visual Inspection with Lugol's Iodine) & to compare sensitivity and specificity of both for detecting Cervical Intraepithelial Neoplasia (CIN) & early carcinoma (Ca) Cervix. Methodology: 300 women (18- 60 yrs) who fulfill selection criteria underwent pap smear & VILI. In pap smear and/or VILI positive patients, cervical biopsy & histopathological examination were done. The sensitivity & specificity of each test were determined and compared. Result & observation: The positive results detected from cytology were 22, VILI was positive in 26 cases. The histology of 19 cases were suggestive of CIN & Ca Cervix. The sensitivity of VILI is 89% (versus pap smear-52%) the specificity of VILI is 96% ( versus pap smear-95%). The accuracy of VILI is 96% compared to pap smear's 93%. Conclusion: The lack of effective & implementable screening programme leads to reporting of advanced cases of Ca Cervix. If detected at CIN or early Ca cervix stage, effective treatment can be provided with encouraging results. Therefore, effective, low cost, convenient & implementable Ca Cervix screening need to be provided in our country.