'National Cancer Center of Mongolia 2 School of Medicine, Health Sciences University of Mongolia
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To evaluate the test parameters of VIA and cervical cytology in 3 Mongolian aimags. From 18 Feb2002 to 12Dec 2004, sexually active women, 30 years or older who had been screened underwent cervical cytology and VIA in the aimags central hospital. All women with abnormal test results and 5% of women with normal results underwent colposcopy with or without biopsy. 2009 women underwent both tests. VIA was abnormal in 254 (12.6%); half did not attend the colposcopy assessment Pap smear showed ASCUS or worse in 3%; 2 patients with HSIL or worse did not return for colposcopy. Of those normal asked to attend colposcopy, 44% attended. Using CIN2 or higher disease on biopsy as the end point, the parameters for VIAA are sensitivity 82.9%, specificity 88.6%, PPV 12.2% NPV 99.7%. The test parameters for Pap smear are sensitivity 88.6%, specificity 98.5% PPV 51.7%, and NPV 99.8%. VIA has acceptable test parameter for population based cervical screening in Mongolia. It is concerning that compliance with colposcopy was only 50%. Thus a method of immediate colposcopy or see and treat is required in this study.
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