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Performance of a low cost magnifying device, Magnivisualizer, versus colposcope for detection of pre-cancer and cancerous lesions of uterine cervix.

Singh V, Parashari A, Gupta S, Sodhani P, Sehgal A - J Gynecol Oncol (2014)

Bottom Line: All women, independently of test results, were referred for colposcopic examination.Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases.However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India. singhveena52@yahoo.co.in.

ABSTRACT

Objective: To assess the performance of a low cost magnifying device (Magnivisualizer) compared to a standard optical colposcope for detection of precancerous and cancerous lesions of the uterine cervix.

Methods: A total of 659 consecutive symptomatic women attending a gynecologic outpatient clinic underwent unaided visual inspection followed by cytology, visual inspection of the cervix using 5% acetic acid (VIA), and VIA under magnification (VIAM) with the Magnivisualizer. All women, independently of test results, were referred for colposcopic examination. Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases.

Results: The detection rate for VIA positive lesions was 12% (134/659), while it was 29% for VIAM positive lesions (191/659). The sensitivities of detection of cervical intraepithelial neoplasia (CIN) 2 and higher lesions were 61.7% for VIA, 88.3% for VIAM, and 86.7% for colposcopy, with a specificity of 58.5% for VIA, 55.8% for VIAM, and 90.4% for colposcopy. The performance of colposcopy and VIAM was moderate (κ, 0.48; 95% confidence interval [CI], 0.41 to 0.54) for detection of CIN 1 and higher lesions and excellent (κ, 0.87; 95% CI, 0.82 to 0.94) for detection of CIN 2 and higher lesions.

Conclusion: In low resource settings, where colposcopic facilities are not available at the community level, a simple low-cost, handheld Magnivisualizer can be considered a valid option for detection of cervical precancerous and cancerous lesions. However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.

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Related in: MedlinePlus

Flow chart of study.
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Figure 1: Flow chart of study.

Mentions: The general screening procedures are shown in the flow chart in Fig. 1. All women underwent sequential examinations using different screening modalities at the same sitting. First, unaided visual inspection was carried out. Subsequently, visual inspection of the cervix was performed using 5% acetic acid (VIA) followed by visual inspection of the cervix under magnification (VIAM). All these screening tests were carried out by trained physicians at the gynecology outpatient unit. All women, independently of test results, were referred to a trained colposcopist (VS) who examined them without knowledge of screening results. Coppelson's colposcopic grading system was adopted for reporting purposes [4]. Colposcopic-directed biopsies were taken from abnormal areas in VIAM positive cases when the colposcopy results were negative.


Performance of a low cost magnifying device, Magnivisualizer, versus colposcope for detection of pre-cancer and cancerous lesions of uterine cervix.

Singh V, Parashari A, Gupta S, Sodhani P, Sehgal A - J Gynecol Oncol (2014)

Flow chart of study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4195297&req=5

Figure 1: Flow chart of study.
Mentions: The general screening procedures are shown in the flow chart in Fig. 1. All women underwent sequential examinations using different screening modalities at the same sitting. First, unaided visual inspection was carried out. Subsequently, visual inspection of the cervix was performed using 5% acetic acid (VIA) followed by visual inspection of the cervix under magnification (VIAM). All these screening tests were carried out by trained physicians at the gynecology outpatient unit. All women, independently of test results, were referred to a trained colposcopist (VS) who examined them without knowledge of screening results. Coppelson's colposcopic grading system was adopted for reporting purposes [4]. Colposcopic-directed biopsies were taken from abnormal areas in VIAM positive cases when the colposcopy results were negative.

Bottom Line: All women, independently of test results, were referred for colposcopic examination.Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases.However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.

View Article: PubMed Central - PubMed

Affiliation: Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India. singhveena52@yahoo.co.in.

ABSTRACT

Objective: To assess the performance of a low cost magnifying device (Magnivisualizer) compared to a standard optical colposcope for detection of precancerous and cancerous lesions of the uterine cervix.

Methods: A total of 659 consecutive symptomatic women attending a gynecologic outpatient clinic underwent unaided visual inspection followed by cytology, visual inspection of the cervix using 5% acetic acid (VIA), and VIA under magnification (VIAM) with the Magnivisualizer. All women, independently of test results, were referred for colposcopic examination. Colposcopic-directed biopsies were obtained from all positive lesions and compared to positive VIAM cases.

Results: The detection rate for VIA positive lesions was 12% (134/659), while it was 29% for VIAM positive lesions (191/659). The sensitivities of detection of cervical intraepithelial neoplasia (CIN) 2 and higher lesions were 61.7% for VIA, 88.3% for VIAM, and 86.7% for colposcopy, with a specificity of 58.5% for VIA, 55.8% for VIAM, and 90.4% for colposcopy. The performance of colposcopy and VIAM was moderate (κ, 0.48; 95% confidence interval [CI], 0.41 to 0.54) for detection of CIN 1 and higher lesions and excellent (κ, 0.87; 95% CI, 0.82 to 0.94) for detection of CIN 2 and higher lesions.

Conclusion: In low resource settings, where colposcopic facilities are not available at the community level, a simple low-cost, handheld Magnivisualizer can be considered a valid option for detection of cervical precancerous and cancerous lesions. However, it cannot replace traditional colposcopy because it has a low specificity that results in many unnecessary biopsies.

Show MeSH
Related in: MedlinePlus