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Efficacy of VIA, VILI, PAP Smear, and FRD Tests in Screening for Cervical Cancer: A Comparative Study

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Indian Journal of Gynecologic Oncology Aims and scope Submit manuscript



To compare the efficacy of VIA, VILI, PAP smear, and FRD tests [Folate Receptor-Mediated Staining solution detection], for cervical cancer screening.


Women attending colposcopy and cervical cancer screening clinic were offered FRD test. This is an applicator to touch the cervix and detect color change using FRD solution. Pap smear was done a day prior to colposcopy. Informed consent was obtained and a calculated sample size of 203 women were enrolled. Colposcopic directed cervical biopsy was taken for 126 women.


The results of screening tests PAP smear, VIA, VILI, VIA/ VILI combination, and FRD test were compared with histopathological reports of cervical biopsy. PAP smears with specificity of 96%, diagnostic accuracy of 92%, had sensitivity of 25%, and missed two cases of cervical cancer and four cases of HSIL. The combination of VIA and VILI tests under 6× magnification showed sensitivity of 100%, specificity of 24.58%, and diagnostic accuracy of 29.37%. FRD tests showed sensitivity of 100%, with nil false-negative results, specificity of 76.27%, and diagnostic accuracy of 77.78%.


Among the screening tests the VIA/VILI combination and FRD tests gave instant results for cervical cancer screening. The FRD test, with higher sensitivity, than that of PAP smear and higher accuracy than that of combined VIA/VILI tests, showed good efficacy to identify CIN2 + lesions in women who would require colposcopy and cervical biopsy for early detection of precancerous lesions of cervix and cervical cancer.

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The authors thank, Prof. S. Shobha, Director of the Institute of Obstetrics and Gynecology, for granting permission and support to conduct the study. They thank all the staff in the Cervical Cancer Screening and Colposcopy Clinic for their support in the data collection. They thank Dr. Zhu for the preliminary statistical analysis.



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Correspondence to D. M. Christe.

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D. M. Christe: Formerly at Regional Centre for Clinical Research in Reproduction, Govt. Hospital for Women and Children, Institute of Obstetrics and Gynecology

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Christe, D.M., Thiripurasundari, G. & Alfonso, T. Efficacy of VIA, VILI, PAP Smear, and FRD Tests in Screening for Cervical Cancer: A Comparative Study. Indian J Gynecol Oncolog 19, 93 (2021).

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