International Journal of Clinical Obstetrics and Gynaecology

Introduction: Cervical cancer remains one of the leading causes of cancer-related deaths among women, particularly in developing countries. Early detection and treatment of pre-invasive lesions are essential to prevent progression to invasive carcinoma. Various screening methods are used to detect such lesions, including the Pap smear, Visual Inspection with Acetic Acid (VIA), and Visual Inspection with Lugol's Iodine (VILI). Each screening method offers different sensitivities and specificities. This study focuses on comparing the diagnostic efficacy of these methods in detecting pre-invasive cervical lesions in women attending a tertiary care hospital.

Aim and Objective: The aim of this study is to evaluate and compare the effectiveness of different screening methods for detecting pre-invasive lesions of carcinoma cervix.

Methods: This cross-sectional study was conducted over a one-year period from January 2023 to December 2023 in the Obstetrics and Gynaecology OPD of MVJ Medical College and Research Hospital Bangalore. A total of 100 women aged 22-60 years, sexually active and meeting the inclusion criteria, were enrolled. Screening methods used were Pap smear, VIA, and VILI. Data were recorded. Statistical analysis was conducted using SPSS 19.0, with the Chi-square test used to find associations, and p-values less than 0.05 were considered significant.

### ROC Curve Analysis

The ROC curve analysis demonstrated the overall diagnostic performance of each screening method. The Area Under the Curve (AUC) values were as follows:

**VILI:** 0.85 (highest diagnostic accuracy)

**VIA:** 0.78

**Pap Smear:** 0.70

These results indicate that VILI had the best balance of sensitivity and specificity among the three screening methods.

Results: Among the 100 women screened, Pap smear showed pre-invasive lesions in 10% of cases, while VIA detected 12% and VILI identified 15%. VIA and VILI showed high sensitivity but lower specificity compared to the Pap smear.

Conclusion: This study concludes that while the Pap smear remains an important screening tool, VIA and VILI are effective alternatives in low-resource settings due to their simplicity and cost-effectiveness. A combination of screening methods may improve overall diagnostic accuracy and ensure early detection and treatment of pre-invasive cervical lesions, thereby reducing the incidence of cervical cancer.