Diagnostic accuracy of visual inspection with acetic acid in diagnosing cervical cancer, taking histopathology as gold standard

Abstract

Objective: To compare the diagnostic accuracy of visual inspection with acetic acid (VIA) in screening cervical cancer, taking histopathology as the gold standard.

Methodology: This analytical, cross-sectional study was performed at the Obstetrics and Gynecology Department of Nishtar Hospital, Multan, Pakistan, during June 2025 to November 2025. A total of 120 women, aged 45–70 years, with symptoms suggestive of cervical malignancy were analyzed through consecutive sampling. VIA was performed using 5% acetic acid under a 100-watt halogen light. Colposcopy-guided cervical biopsy was taken among females, and histopathology served as the gold standard. Data were analyzed employing IBM-SPSS Statistics, version 26.0. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of VIA were calcualted.

Results: Among 120 women, the mean age was 52.0±5.6 years, and median parity 3.0 (2.0–4.0). Postmenopausal status was positive among 90 (75.0%) females, and 100 (83.3%) were residing in rural areas of residence. VIA, and histopathology were positive in 98 (81.7%), and 97 (80.8%) women, respectively. VIA showed sensitivity, specificity, PPV, NPV, and accuracy of 96.9%, 82.6%, 95.9%, 86.4%, and 94.2%, respectively. Stratified analysis across subgroups revealed sensitivity ranging from 91.7%-100%, and accuracy between 88.6%-96.5%.

Conclusion: The VIA demonstrated high sensitivity, specificity, and diagnostic accuracy when compared with histopathology in detecting cervical cancer among symptomatic women.