Inspeksi Visual Asam Asetat (IVA) untuk Deteksi Dini Lesi Prakanker Serviks

Abstract

Visual acetic acid inspection (IVA) for early cervix pre cancer lesion detection Background: In 1985 WHO and had recommended an alternative approach, the down staging concept of cervical malignancy with visual inspection with acetic acid (VIA) for developing countries. Displastic cervical epithelial cells will make an acethowhite appearance with VIA. It is important to know the sensitivity and specificity of VIA for early detection of cervical precancer lesion. Methods: A hundred and twenty subjects who fullfilled inclution criteria had Pap test, VIA and four quadrant biopsy. Fortyfive subjects came from Gynecology and fertility clinic at Dr. Kariadi hospital and seventy five subjects came from Indonesian Cancer Foundation Semarang. From all of these examination the sensitivity, specificity, positive predictive value and negative predictive value were calculated by 2x2 tabel. Biopsy result was considered as gold standard. Results: Based on biopsy result there were 32 cases (26.7%) with normal finding, 31 cases (25.81%) with chronic cervicitis, 50 cases (41.6%) with chronic cervicitis with mild dysplasia, 3 cases (2.5%) with chronic cervicitis and moderate dysplasia, 2 cases (1.7%) with non specific inflammation, 2 cases (1.7%) with chronic cervicitis and mild dysplasia, 1 cases (0.8%) with malignancy. The sensitivity of Pap test was 55%, specificity 90%, PPV 84% and NPV 69% whether VIA had sensitivity 84%, specificity 89%, PPV 87% and NPV 86%. Conclusions: Visual inspection with acetic acid has high sensitivity for early detection of cervical precancer lesion.