Early detection of cervical neoplasia by visual screening and hybrid capture testing by self and physician collection methodology - A community based study in rural area

Naked eye visual inspection of the cervix after application of acetic acid (VIA) and HPV testing are alternative methods for cervical cancer screening in low resource settings for reducing the burden of the disease. The high sensitivity and low specificity of VIA results in high referral rates. HPV testing has been shown to be a better screening test than Pap smear and is now being recommended as the method of primary screening for cervical cancer. However, it still suffers from some of the drawbacks of Pap smear. The requirement for a health care provider to collect the samples and many logistic requirements at the periphery, such as examination facilities, sterile speculums, light source, etc., still remain. Self-sampling has shown to have 94% concordance with cervical sampling in our pilot study and was found to have good acceptability among Indian women. The aim of this study is to assess the feasibility and reliability of this method in the community setting, as a model for cervical cancer screening at the primary health centres and sub-centres.