Diagnostic accuracy of visual inspection of cervix using lugol’s iodine for detecting cervical carcinoma taking histopathology as a gold standard
Visual Inspection of Cervix Using Lugol’s Iodine
DOI:
https://doi.org/10.54393/pjhs.v3i07.330Keywords:
Visual Inspection, VILI, Cervical Malignancy, HistopathologyAbstract
Cervical cancer arises from the transformation zone of the cervix. Diagnosis is usually made by screening later confirmed by a biopsy. In low resource setups, where modern methods are not suitable, an alternate method is to inspect the cervix with naked eye after applying Lugol’s iodine as it highlights the precancerous lesions. Objective: To look for the diagnostic accuracy of visual investigation of cervix using lugol’s iodine (VILI) for detecting the cervical cancer taking histopathology as a gold standard. Methods: Cross sectional study was conducted at Obstetrics and Gynecology department, Services Hospital, Lahore for six months from 1st July 2021 to 31st December 2021. 150 patients were examined using lugol’s iodine solution and then underwent colposcopy to determine the diagnostic accuracy of lugol’s iodine in cervical carcinoma while setting histopathology as a gold standard. Results: The mean age of the patients was 42.11 ± 10.12 years. 8.67% patients were nulliparous, 13.33% registered patients were with parity one, 38.67% patients with parity two, 29.33% patients were with parity three and 10% patients were para four. The sensitivity, specificity, and diagnostic accuracy of VILI was found to be 92.59%, 93.75% and 93.33% respectively, taking histopathology as gold standard. Conclusions: According to results of our study we can say that the visualizing the cervix using lugol’s iodine (VILI) can be used for detection of cervical cancer
References
Sankaranarayanan R and Boffetta P. Research on cancer prevention, detection and management in low-and medium-income countries. Annals of Oncology. 2010 Oct; 21(10): 1935-43. doi: 10.1093/annonc/mdq049.
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2021 May; 71(3): 209-49. doi: 10.3322/caac.21660.
Abbas G, Shah S, Hanif M, Asghar A, Shafique M, Ashraf K. Cancer prevalence, incidence and mortality rates in Pakistan in 2018. Bull Cancer. 2020 Apr; 107(4): 517-8. doi: 10.1016/j.bulcan.2019.12.011.
Li YX, Luo HX, Wang W, Wang Z, Zhao WH, Hao M. Diagnostic accuracy of novel folate receptor-mediated staining solution detection (FRD) for CIN2+: A systematic review and meta analysis. Medicine. 2021 May; 100(20): e26004. doi: 10.1097/MD.0000000000026004.
Mishra GA, Pimple SA, Shastri SS. An overview of prevention and early detection of cervical cancers. Indian Journal of Medical and Paediatric Oncology. 2011 Jul; 32(03):125-32.
Bouvard V, Wentzensen N, Mackie A, Berkhof J, Brotherton J, Giorgi-Rossi P, et al. The IARC perspective on cervical cancer screening. New England Journal of Medicine. 2021 Nov; 385(20): 1908-18. doi: 10.1056/NEJMsr2030640.
ICO/IARC Information Centre on HPV and Cancer. Human Papillomavirus and Related Cancers, Fact Sheet 2021. Available at: https://hpvcentre.net/statistics/reports/PAK_FS.pdf
Hillemanns P, Soergel P, Hertel H, Jentschke M. Epidemiology and early detection of cervical cancer. Oncology research and treatment. 2016; 39(9):501-6.
UNFPA Asia-Pacific Regional Office. Pakistan: Cervical Cancer Elimination - Country Review and Roadmap for Action. 2022 Jan. Available at: https://asiapacific.unfpa.org/en/publications/pakistan-cervical-cancer-elimination-country-review-roadmap-action
Catarino R, Schäfer S, Vassilakos P, Petignat P, Arbyn M. Accuracy of combinations of visual inspection using acetic acid or lugol iodine to detect cervical precancer: a meta‐analysis. BJOG: An International Journal of Obstetrics and Gynecology. 2018 Apr; 125(5): 545-53. doi: 10.1111/1471-0528.14783.
Egede J, Ajah L, Ibekwe P, Agwu U, Nwizu E, Iyare F. Comparison of the accuracy of papanicolaou test cytology, Visual Inspection with Acetic acid, and Visual Inspection with Lugol Iodine in screening for cervical neoplasia in southeast Nigeria. Journal of Global Oncology. 2018 Feb; 4: 1-9. doi: 10.1200/JGO.17.00127.
Zlatkov V. Is there a place for via and vili in our practice. Akusherstvo i Ginekologiia. 2016 Jan; 55: 29-35.
World Health Organization (WHO). Cervical cancer. 2022. [Last Cited: 22nd Feb 2022]. Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer
Shin MB, Liu G, Mugo N, Garcia PJ, Rao DW, Bayer CJ, et al. A framework for cervical cancer elimination in Low-and-Middle-Income countries: a scoping review and roadmap for interventions and research priorities. Frontiers in public health. 2021 Jul; 9: 758. doi: 10.3389/fpubh.2021.670032.
Bryan JT, Buckland B, Hammond J, Jansen KU. Prevention of cervical cancer: journey to develop the first human papillomavirus virus-like particle vaccine and the next generation vaccine. Current opinion in chemical biology. 2016 Jun; 32: 34-47. doi: 10.1016/j.cbpa.2016.03.001.
Aoki ES, Yin R, Li K, Bhatla N, Singhal S, Ocviyanti D, et al. National screening programs for cervical cancer in Asian countries. Journal of Gynecologic Oncology. 2020 May; 31(3): e55. doi: 10.3802/jgo.2020.31.e55.
Arbyn M, Sankaranarayanan R, Muwonge R, Keita N, Dolo A, Mbalawa CG, et al. Pooled analysis of the accuracy of five cervical cancer screening tests assessed in eleven studies in Africa and India. International Journal of Cancer. 2008 Jul; 123(1): 153-60. doi: 10.1002/ijc.23489.
Catarino R, Schäfer S, Vassilakos P, Petignat P, Arbyn M. Accuracy of combinations of visual inspection using acetic acid or lugol iodine to detect cervical precancer: a meta‐analysis. BJOG: An International Journal of Obstetrics and Gynaecology. 2018 Apr; 125(5): 545-53. doi: 10.1111/1471-0528.14783.
Pimple S, Mishra G, Shastri S. Global strategies for cervical cancer prevention. Current Opinion in Obstetrics and Gynecology. 2016 Feb; 28(1): 4-10. doi: 10.1097/GCO.0000000000000241.
Castle PE and Pierz A. (At least) once in her lifetime: global cervical cancer prevention. Obstetrics and Gynecology Clinics. 2019 Mar; 46(1): 107-23. doi: 10.1016/j.ogc.2018.09.007.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments