VIA as a Screening Test for Early Detection of Cervical Cancer
The visual inspection with acetic acid (VIA) screening method developed
in 2000 has proved to be a valuable tool for cervical cancer screening
that developing countries so desperately need. The attractiveness of
this simple screening method is based on its ability to be incorporated
into a linked ‘screen and treat’ strategy. Integrating screening and
treatment that bypasses the need for a protracted wait for screening
results and potential loss of follow-up appointments, which is endemic
in LMIC countries. Further advantages are the low cost, ability to be
performed by trained nurses and lack of need for laboratory facilities
or diagnostic equipment. While VIA is more sensitive than cytology with
a sensitivity of 76·7% compared to 44·3% for cytology, it is less
specific with a specificity of 64·1% compared to 90·6% for cytology10. Despite this, VIA remains an attractive option,
especially in rural areas, where medical and pathology services are not
well developed. Unfortunately, to date VIA has been slow in being rolled
out in developing countries (especially in the rural areas where it is
needed most) as the average screening coverage in Sub-Saharan Africa is
only 12.12% 11