Acetic acid test: a promising screening test for early detection of cervical cancer

OBJECTIVE: To determine whether the acetic acid test (AAT) could be used as a screening testfor early detection of cervical cancer. STUDY DESIGN: A hospital-based study was carried out. A sample of 376 women who attended the early cancer detection program of the Instituto Mexicano del Seguro Social in the state of Durango during 1998 was included. The AAT was applied during the gynecologic examination. Each women underwent colposcopy and directed cervical biopsy. RESULTS: The biopsies revealed that five women had cervical intraepithelial neoplasia grade 1 (CIN 1) and 51, 2/3. Four values (true positive,false positive, false negative and true negative) were obtained according to the pathologic test for CIN 1(5, 129, 0 and 191) andfor CIN 2/3 (47, 129, 4 and 191). Sensitivity, specificity, negative predictive value and positive predictive value in women with CIN 1 were 1.00, .60, 1.00 and .04 and with CIN 2/3 were .92, .60, .98 and .27, respectively. CONCLUSION: This test is promisingfor early detection of cervical cancer given its high sensitivity. Understanding the biologic mechanisms underlying acetowhite changes necessitates further studies.