COLPOSCOPIC ASSESSMENT OF VIA-POSITIVE WOMEN WITH UNHEALTHY CERVIX AT A TERTIARY CARE CENTRE
Main Article Content
Keywords
Cervical cancer; VIA positive; Bad cervix; Colposcopy; Reid’s colposcopic index; Cervical intraepithelial neoplasia; Tertiary care.
Abstract
Cervical cancer remains a leading cause of morbidity and mortality among women in developing countries. Visual inspection with acetic acid (VIA) has been widely implemented as a low-cost screening tool. Colposcopy serves as a valuable diagnostic method to assess VIA-positive women, particularly those with clinically unhealthy or “bad” cervix, enabling early detection of premalignant and malignant lesions.
Aim: To evaluate colposcopic findings in VIA-positive women with bad cervix and to correlate them with clinical and per speculum features for early detection of cervical intraepithelial neoplasia (CIN) and carcinoma.
Methods: This prospective observational study included 150 VIA-positive women aged 21–65 years attending the gynecology outpatient department of a tertiary care centre. Participants presented with symptoms such as discharge, postcoital bleeding, dyspareunia, or abnormal cervical appearance. Colposcopic examination was performed using the Modified Reid’s Colposcopic Index, and targeted biopsies were obtained. Findings were classified as normal, inflammatory, CIN I–III, or carcinoma.
Results: The most common presenting complaint was vaginal discharge (40%), followed by lower abdominal pain (26%) and postcoital bleeding (16%). On per speculum examination, hypertrophied cervix (28%) and unhealthy discharge (23%) were frequent findings. Colposcopy revealed normal cervix in 21% and abnormal changes in 79% of cases. Reid’s index indicated low-grade lesions in 31%, indeterminate lesions in 18%, and high-grade lesions in 30%. Final colposcopic diagnosis identified CIN 1 in 31%, CIN 2 in 18.6%, CIN 3 in 10%, and carcinoma cervix in 5.3% of cases.
Conclusion: Colposcopy is an essential adjunct in the evaluation of VIA-positive women with bad cervix. It enhances diagnostic accuracy, facilitates early detection of CIN and carcinoma, and strengthens the cervical cancer screening pathway in resource-limited settings.
References
2. Wu J, Jin Q, Zhang Y, Ji Y, Li J, Liu X, et al. Global burden of cervical cancer: current estimates, temporal trend and future projections based on the GLOBOCAN 2022. J Natl Cancer Cent [Internet]. 2025 Jun 1 [cited 2025 Aug 8];5(3):322–9. Available from: https://www.sciencedirect.com/science/article/pii/S2667005425000134
3. Moore DH. Cervical cancer. Obstet Gynecol. 2006 May;107(5):1152–61.
4. Martin-Hirsch P, Wood WJ. Cervical cancer. BMJ Clin Evid. 2020;2011.
5. Azene GK. Visual inspection with acetic-acid (VIA) service utilization and associated factors among women in Hawassa city, southern Ethiopia: a community based cross-sectional study. Women’s Midlife Heal [Internet]. 2021;7(1):6. Available from: https://doi.org/10.1186/s40695-021-00065-4
6. Muwonge R, Manuel MDG, Filipe AP, Dumas JB, Frank MR, Sankaranarayanan R. Visual screening for early detection of cervical neoplasia in Angola. Int J Gynecol Obstet. 2010;111(1):68–72.
7. Adler DH, Wallace M, Bennie T, Mrubata M, Abar B, Meiring TL, et al. Cervical dysplasia and high-risk human papillomavirus infections among HIV-infected and HIV-uninfected adolescent females in South Africa. Infect Dis Obstet Gynecol. 2014;2014.
8. Qin D, Bai A, Xue P, Seery S, Wang J, Mendez MJG, et al. Colposcopic accuracy in diagnosing squamous intraepithelial lesions: a systematic review and meta-analysis of the International Federation of Cervical Pathology and Colposcopy 2011 terminology. BMC Cancer. 2023 Feb;23(1):187.
9. Ashmita D, Shakuntala P N, Rao SR, Sharma SK, Geethanjali S. Comparison and Correlation of PAP Smear, Colposcopy and Histopathology in Symptomatic Women and Suspicious Looking Cervix in a Tertiary Hospital Care Centre. Int J Heal Sci Res [Internet]. 2013;3(5):50. Available from: www.ijhsr.org
10. Kohale MG, Dhobale A V, Hatgoankar K, Bahadure S, Salgar AH, Bandre GR. Comparison of Colposcopy and Histopathology in Abnormal Cervix. Cureus. 2024;16(2).
11. Navya B, Wijeratne R, Go DR, R Alva DS. Comparison of Diagnostic Accuracy of Colposcopic Findings Using Modified Reid Colposcopic Index with Histopathology in Cervical Lesions. IOSR J Dent Med Sci. 2016;15(10):129–33.
12. Panwar DK, Tyagi DS, Maheshwari PB. Correlation of colposcopic findings with biopsy in cervical cancer screening. Int J Clin Obstet Gynaecol. 2020;4(4):128–31.
13. Prathima S, Sarojini, Latha B, Ashakiran TR. Study of Prevalence of Abnormal Pap Smear and its Associated Risk Factors in HIV Positive Women: A Cross-sectional Study. J Obstet Gynecol India [Internet]. 2022;72(s1):255–61. Available from: https://doi.org/10.1007/s13224-021-01533-7
14. Asati P, Sultan S, Nigam R., Asati S. Study of colposcopic and histopathological correlation for cervical lesion at tertiary care: An original research. Int J Health Sci (Qassim). 2022;6(June):2672–82.
15. Basu DP, Sankaranarayanan DR. Colposcopy Digital Atlas [Internet]. Scr Publications. 2017 [cited 2025 Jan 15]. Available from: https://screening.iarc.fr/atlascolpodetail.php?Index=015&e=,0,1,2,3,8,10,15,19,30,31,43,46,47,60,61,68,73,83,88,89,93,96,102,105,111
16. Massad LS, Perkins RB, Naresh A, Nelson EL, Spiryda L, Gecsi KS, et al. Colposcopy Standards: Guidelines for Endocervical Curettage at Colposcopy. J Low Genit Tract Dis. 2023;27(1):97–101.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Arushi Mangal
Designation: Resident, Department of Obstetrics and Gynaecology, Gandhi medical College, Bhopal, Email: arushimangal2204@gmail.com
Dr Bharti Parihar
Professor, Department of Obstetrics and Gynaecology, Gandhi medical College, Bhopal
Dr Taruna Garva
Senior Resident AIIMS Bhopal.
