Percent of VIA (visual inspection with acetic acid) screenings that test positive

Percent of VIA (visual inspection with acetic acid) screenings that test positive

Percent of VIA (visual inspection with acetic acid) screenings that test positive

The percent of cervical cancer screenings using visual inspections with acetic acid (VIA) (also referred to as direct visual inspection), within a given timeframe (e.g. monthly, quarterly, annually), that test positive for precancerous lesions.

This indicator is calculated as:

(Number of VIA screenings that test positive / Total number of VIA screenings conducted within given timeframe) x 100

Data Requirement(s):

Number of women screened for cervical cancer using the VIA method within given timeframe; number of positive VIA results

Health facility records

Due to non-existent or poorly executed cervical cancer prevention programs, approximately 80% of all cases of cervical cancer globally occur in less-developed countries (ACCP, 2004). To address this problem, VIA, an inexpensive yet effective screening procedure which has been endorsed by the WHO, has been developed for a wide range of settings.  VIA entails brushing acetic acid (vinegar) on a woman’s cervix which makes precancerous spots turn white.  They can immediately be frozen off using the cryotherapy method.  No laboratory processing is required, only simple equipment and supplies are needed, the results are immediate, the client can be treated in the same visit, and all care can be provided by a trained nurse (Dherbeys, 2011).    

Although test specificity for VIA screenings is moderate, this indicator determines incidence of precancerous lesions, which is critical information for cervical cancer prevention programs.

Although VIA reveals pre-tumors with more accuracy than a typical Pap smear, it also has more false positives.  Because VIA-positive lesions are not unique to precancer, a considerable proportion of women will be unnecessarily treated for precancer or referred for further management, which can overload the service site where treatment is being offered (AACP, 2004).  However, when screening tests with the inherent potential for overtreatment, such as visual methods, are combined with an outpatient treatment method that is safe, relatively inexpensive, and acceptable, the overall benefit can outweigh the limitations.

VIA is subjective because the outcome depends on the clinician’s interpretation of what is seen on the cervix.  Also, it is not an appropriate screening method for post-menopausal women.

Alliance for Cervical Cancer Prevention (ACCP). Planning and Implementing Cervical Cancer Prevention and Control Programs: A Manual for Managers. Seattle: ACCP; 2004.

Dherbeys, A. Fighting Cervical Cancer with Vinegar and Ingenuity.  2011, September 26.  The New York Times.

Related content

Sexually Transmitted Infections and HIV/AIDS