Performance of a low cost magnifying device, magnivisualizer, versus colposcope for detection of pre-cancer and cancerous lesions of uterine cervix.
10.3802/jgo.2014.25.4.282
- Author:
Veena SINGH
1
;
Aditya PARASHARI
;
Sanjay GUPTA
;
Pushpa SODHANI
;
Ashok SEHGAL
Author Information
1. Division of Clinical Research, Institute of Cytology and Preventive Oncology, Noida, India. singhveena52@yahoo.co.in
- Publication Type:Original Article ; Comparative Study ; Evaluation Studies ; Research Support, Non-U.S. Gov't
- Keywords:
Ambulatory care facilities;
Colposcopy;
Sensitivity and Specificity;
Uterine cervical dysplasia;
Uterine cervical neoplasms
- MeSH:
Acetic Acid/diagnostic use;
Adult;
Aged;
Biopsy/methods;
*Colposcopes;
Colposcopy;
Early Detection of Cancer/*instrumentation/methods;
Equipment Design;
Female;
Humans;
Middle Aged;
Neoplasm Grading;
Optical Imaging/*instrumentation/methods;
Outpatient Clinics, Hospital;
Reproducibility of Results;
Uterine Cervical Dysplasia/*diagnosis/pathology;
Uterine Cervical Neoplasms/*diagnosis/pathology
- From:Journal of Gynecologic Oncology
2014;25(4):282-286
- CountryRepublic of Korea
- Language:English
-
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 (kappa, 0.48; 95% confidence interval [CI], 0.41 to 0.54) for detection of CIN 1 and higher lesions and excellent (kappa, 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.
