UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2015 UpToDate®

Cervical cancer screening tests: Visual inspection methods

Author
Lynette Denny, MD, PhD
Section Editor
Barbara Goff, MD
Deputy Editor
Sandy J Falk, MD, FACOG

INTRODUCTION

Visual inspection of the cervix after application of Lugol's iodine, the first method used for cervical cancer screening, was introduced in the 1930s by Schiller [1]. However, Schiller's test has poor specificity and was almost entirely replaced with the advent of cervical cytology.

Current cervical cancer screening protocols typically include a combination of cervical cytology and human papillomavirus (HPV) testing. Visual inspection of the cervix has reemerged as a screening tool for low resource settings, despite its limited specificity, since it is economical and provides immediate results. Visual inspection can be performed with acetic acid (VIA) or Lugol's iodine (VILI). These procedures are also referred to as Visual Inspection with Acetic Acid (VIA) or Visual Inspection with Lugol’s Iodine (VILI).

Techniques for performing visual inspection of the cervix will be reviewed here. The utility of visual inspection methods, strategies for cervical cancer screening, and techniques for other tests are discussed separately. (See "Screening for cervical cancer in resource-limited settings" and "Screening for cervical cancer" and "Cervical cancer screening tests: Techniques for cervical cytology and human papillomavirus testing".)

INDICATIONS

Visual inspection is indicated for women for whom cervical cancer screening is recommended and for whom these methods are the best screening option (ie, women who do not have access to cervical cytology and HPV testing). (See "Screening for cervical cancer in resource-limited settings", section on 'Approach to cervical cancer screening'.)

CONTRAINDICATIONS

There are NO absolute contraindications to visual inspection of the cervix. VIA, rather than VILI, should be performed in women with an allergy to iodine. Visual inspection can be performed during pregnancy, but cervical biopsies are relatively contraindicated in pregnant women unless invasive cancer is suspected.

           

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Dec 2014. | This topic last updated: May 6, 2013.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2015 UpToDate, Inc.