TMSS Medical College Journal

Background: Cervical cancer remains a leading cause of morbidity and mortality among women in low- and middle-income countries (LMICs), particularly in Bangladesh. Visual Inspection with Acetic Acid (VIA) has emerged as a cost-effective and feasible screening method for early detection of cervical lesions in resource-limited settings. This study evaluates VIA in detecting cervical cancer and precancerous lesions, with colposcopy directed Biopsy and histopathology as the gold standard in TMSS Medical College and Rafatullah Community Hospital. Materials and Methods: This observational study was conducted from January 2022 to June 2023 in the Department of Obstetrics and Gynecology, TMSS Medical College and Rafatullah Community Hospital, Bogura, among 210 women presenting with multiple indications of cervical cancer. Data were collected and analyzed using SPSS version 25. Descriptive statistics were used to summarize demographic and clinical characteristics. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were calculated using standard diagnostic values, holding colposcopy directed Biopsy and histopathological diagnosis as the gold standard. Results: Of the 210 participants, 74.76% (n=157) tested positive with VIA, and 25.24% (n=53) tested negative. Histopathological analysis showed that 30.48% had normal findings, 24.29% had atypia, 20.95% had CIN-1, and 11.43% had CIN-2. VIA demonstrated a sensitivity of 95.89%, specificity of 73.44%, accuracy of 89.05%, PPV of 89.17%, and NPV of 88.68%. While VIA showed high sensitivity, its moderate specificity indicated the potential for false positives. Conclusion: VIA is a highly sensitive and practical screening tool for cervical cancer in low-resource settings like Bangladesh. However, its moderate specificity and the presence of false positives suggest the need for improved diagnostic protocols, potentially involving adjunctive tests. The integration of VIA into national screening programs could enhance carly detection rates and contribute in reducing cervical cancer-related mortality in LMICs.

Cervical cancer remains a significant global health burden, especially among women in low- and middle-income countries (LMICs). It is the fourth most common cancer affecting women worldwide, with an estimated 662,301 new cases and 348,874 deaths according to GLOBOCAN in 2022, making it a leading cause of cancer-related mortality among women globally. Of these deaths, nearly 90% occur in LMICs, highlighting the critical role of socioeconomic factors in disease progression and outcomes.' In Bangladesh and other South Asian countries, the situation is particularly dire, with cervical cancer being the second most common cancer among women. According to national cancer registry data, the incidence of cervical cancer in Bangladesh is alarmingly high, and mortality rates remain elevated due to inadequate screening and treatment facilities.