Diagnosing cervical cancer can now actually be cheaper than buying yourself a bar of chocolate as a recently published study by the Sir Ganga Ram Hospital has found that for cervical cancer, the Visual inspection with acetic acid (VIA) test which costs just Rs 2 is as effective as a pap smear test, which is currently the gold standard but costs more than Rs 1,000. This study has huge implications for countries like India as it can minimise medical expenditure by a huge margin.
According to the study, VIA can be used as an effective screening modality in low resource settings, especially in developing countries like India, where the expertise for definitive tests is not available in rural and semi-urban areas.
“VIA in comparison to pap smear is not only easy to use but also easy to interpret and reliable with quick results. In contrast, pap smear test is laboratory based, expensive, requires expertise and therefore may not be available everywhere. The results of VIA are available immediately whereas for pap smear test, it requires a follow-up visit,” said the study.
A cross-sectional study on 500 women was conducted by researchers from Department of Obstetrics and Gynaecology at the Sir Ganga Ram Hospital. The study, published in the August 2014 edition of Journal of Current Medicine Research and Practice, evaluated the utility of VIA for screening of precancerous or cancerous lesions of cervix and compared it with Papanicolaou Smear (pap smear).
According to Dr Harsha Khullar, corresponding author of the study and senior consultant, Department of Obstetrics and Gynaecology, “In our study, we evaluated the utility of VIA for the diagnosis of pre-invasive and invasive carcinoma cervix and compared with pap smear. We found that sensitivity of VIA and pap smear in our study to diagnose precancerous and invasive disease was comparable. For VIA, sensitivity was 93.1 per cent and for pap smear was 86.2 per cent. Both screening tests had low specificity, VIA 32.2 and pap smear 60.0.”
Dr Geeta Mediratta, author of the study and senior consultant, Department of Obstetrics and Gynaecology, added, “Our findings suggest that VIA with a high sensitivity is comparable to pap smear and can be used as an alternate screening test especially in low resource settings where the expertise for definitive tests is not available.”
“VIA is a simple outpatient (OPD) procedure, inexpensive and results are available immediately. The ‘screen and refer’ approach for further testing can be used,” said Dr Neha Puri, author of the study and DNB student, Department of Obstetrics and Gynaecology.
Dr Khullar further added, “The VIA test is not only simple to perform but is also very cost-effective. To screen 100 patients, the cost of VIA is Rs 200 whereas Pap Smear test on same number of patients cost Rs 20,000.”