Effectiveness of cervical cancer screening using visual inspection with acetic acid in Peru

ObjectiveTo evaluate the effectiveness of screening using visual inspection with acetic acid (VIA).MethodsIn a low-resource area of Peru in 2005–2008, a randomly selected sample of women who had previously screened negative by VIA and Pap (intervention group), and a group of eligible women previously unscreened by VIA (comparison group) were screened by VIA. The outcome measures were histologically confirmed cervical intraepithelial neoplasia (CIN) 2–3 and invasive cervical cancer.ResultsThere were 4252 women in the intervention group and 4392 in the comparison group. Histologically confirmed CIN 2 or worse was diagnosed in 31 (0.7%) and 115 (2.6%) women, and invasive cancer was diagnosed in 4 women (0.09%) and 43 women (1.00%), in the intervention and comparison groups, respectively. The adjusted odds ratio was 4.2 (95% confidence interval [CI], 2.7–6.4) for CIN 2 or worse, and 13.9 (95% CI, 4.9–39.6) for invasive cervical cancer in the comparison group.ConclusionA lower prevalence of CIN 2–3 and invasive cervical cancer was seen in women previously screened by VIA, as compared with women not previously screened by VIA, implying that a single VIA screening can lower the population risk for cervical cancer.