Reference Manual - IARC Screening Group

Tests for Cervical Cancer ScreeningVILIDEFINITION/MECHANISM OFACTIONPROCEDURE BENEFITS LIMITATIONSVisual examination of theexocervix and SCJ usingthe naked eye(unmagnified) and Lugol’sIodineUsed solely as a screeningtestResults reported as:• Test-positive• Test-negative• Suspicious for CancerProcedure is described towoman• Reason• Procedure (what toexpect)• FollowupInsert the speculumView the cervixWash the cervix with aLugol’s Iodine solutionInspect the cervixincluding the SCJ withthe naked eyeClean the cervix andvagina carefully after theprocedure as the iodinesolution can stainclothing and linen if itdrips out of the vaginaMeets criteria of a goodscreening test, butLugol’s Iodine lessavailable and moreexpensive than acetic acid(vinegar)Initial assessments ofsensitivity and specificityindicate it is comparableto Pap smear, HPV orcolposcopyPotential for single visitapproachRequires no equipment/maintenance other thansupply of Lugol’s Iodine,speculum and light source(torch)Can be performed at anylevel of the healthcaresystem, by a mid-levelprovider with propertrainingFew published studiesdocumenting the value asa screening test in widescaleuseFalse positives mayoverload the referralsystemRequires competencybasedtraining in order toinspect and makeassessmentA-8 Cervical Cancer Prevention Guidelines for Low-Resource Settings