Detection Increase of cervix lesions by means of visual examination in Puerto Esperanza, 2008
Keywords:
Precancerous conditions, Cervix uteri, Cytodiagnosis, Uterine cervical neoplasms, Coldposcopía.Abstract
Visual examination of cervix using acetic acid up to 4-5% (VIA) and Lugol's solution (VILI) contribute to detect lesions. This constitutes the first report of their use in Cuba.Objective: to demonstrate the detection increase of pre-malignant and malignant cervical lesions by means of visual examination in Primary Health Care.
Method: control-case studies in Puerto Esperanza, Viñales municipality in 2008.
Target group: women from 15 to 64 years old who practice penetrating sexual relations. Sample: women who underwent visual examinations and altered cytology (n1= 18 cases) or not (n2= 178 controls). In Cervix Pathology Office, colposcopies either by directed biopsy or conization with diathermal ansa were practiced; calculating absolute and relative percentage frequencies and the probability to detect lesions by isolated tests or in set, together with the tests of diagnostic performance.
Results: VIA and VILI were positive in 92.9% and 79.6%, respectively. The joint probability of presenting lesions was 0. 7395. Those showing altered cytology (88.9%) had positive VIA and 77, 9% positive VILI. Colposcopy resulted positive in 70.9% and the probability of having a lesion, proved by visual examination, simultaneously with colposcopy was 0.516. Biopsies performed to 136 women were useful (99.3%), out of them, almost 50% presented pre-malignant and malignant lesions. Yield tests were superior to VIA and VILI than to cytology. Non-invasive cancer was detected; however in situ carcinoma was. Conclusion: visual examination increased the number of diagnosis 4 times, thus its use must be generalized.
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