CHAPTER 4: SCREENING FOR CERVICAL CANCER

PS 10: Visual Screening Methods 123PRACTICE SHEET 10: VISUAL SCREENING METHODSIn a visual test, the provider applies acetic acid (in VIA) or Lugol’s iodine solution (inVILI) to the cervix, and then looks to see if there is any staining. A VIA test is positiveif there are raised and thickened white plaques or acetowhite epithelium; a VILI testis positive if there are mustard or saffron-yellow coloured areas, usually near theSCJ. Either test is suspicious for cancer if a cauliflower-like fungating mass or ulceris noted on the cervix. Visual screening results are negative if the cervical lining issmooth, uniform and featureless; it should be pink with acetic acid and dark brown orblack with Lugol’s iodine.The following materials and equipment are needed for visual methods:• soap and water for washing hands;• a bright light source to examine the cervix;• a speculum, high-level disinfected (it need not be sterile);• disposable or high-level disinfected examination gloves (need not be sterile);• examination table covered by clean paper or cloth;• cotton-tipped swabs;• dilute acetic acid solution (3–5%) or white vinegar;• Lugol’s iodine solution;• 0.5% chlorine solution for decontaminating instruments and gloves;• recording form.PS 10Practice Sheet 10: Visual Screening MethodsPERFORMING VISUAL SCREENING TESTSNote the following:• Visual methods are not recommended for use in postmenopausal women, becausetheir transition zone is most often inside the endocervical canal and not visible onspeculum inspection.Preparation1. Explain the procedure, how it is done, and what a positive testmeans. Ensure that the woman has understood and obtaininformed consent.2. Do a speculum examination as described in Practice Sheet 7.PS6Informed consentPS7PS7 Pelvic exam