%0 Journal Article
%T Visual inspection for cervical cancer screening; evaluation by doctor versus paramedical worker
%A Bhatla Neerja
%A Mukhopadhyay A
%A Joshi S
%A Kumar A
%J Indian Journal of Cancer
%D 2004
%I Medknow Publications
%X BACKGROUND : In the absence of an effective cervical cancer screening programme, efforts are being made to explore the feasibility of using the existing infrastructure to develop effective low-cost screening methods. AIMS : To evaluate and compare test performance of visual inspection of the cervix by a doctor and a paramedical worker. SETTING AND DESIGN : Gynaecology outpatient department (OPD), All India Institute of Medical Sciences, New Delhi; cross-sectional study. MATERIAL AND METHODS : One hundred women with complaints of vaginal discharge, irregular bleeding, post coital bleeding or unhealthy cervix underwent visual inspection with acetic acid (VIA) and Lugol¡äs iodine (VILI) by a doctor and nurse, followed by colposcopy and biopsy. STATISTICAL ANALYSIS USED : Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each test and compared. Concordance was determined by kappa statistics. RESULTS : VIA by nurse had a higher sensitivity (100% versus 87.5%), but lower specificity (53% versus 63%) when compared with the doctor, but it was not statistically significant. There was moderate agreement between their VIA findings (kappa=0.56). VILI findings were comparable to that of the VIA, both by the doctor and nurse. There was almost perfect agreement (kappa=0.89) between VILI by the doctor and nurse. CONCLUSION : Visual inspection can be performed reliably by trained paramedical workers and doctors and is an effective screening option in low resource settings.
%K Cervical cancer
%K Screening
%K Visual inspection with acetic acid
%K Visual inspection with Lugol¡äs iodine
%K paramedical.
%U http://www.indianjcancer.com/article.asp?issn=0019-509X;year=2004;volume=41;issue=1;spage=32;epage=36;aulast=Bhatla