Introduction: Visual inspection with acetic acid may be considered as an alternative to Pap smear among
women who do not have access to cervical cytology and HPV testing because of its ease of use, low-cost
and fewer physician visits. Objective: This study aimed to evaluate the comparability of visual inspection
with acetic acid (VIA) with Pap smear as a screening test for early signs of cervical pathology.
Methods: A total of 64 women were tested, who are sexually active, between the ages of 21 to 49 (with
the mean age of 35.4), from a Rural Health Unit of both Barangay Balibago and Barangay Sto. Domingo
in Angeles City. Firstly, taking cytologic samples for Pap smear, followed by the direct inspection after
applying acetic acid; the Pap smears were sent to a pathologist for evaluation, while direct visual
inspection with acetic acid were evaluated by a gynecologist on the spot. Results: From the 64 women
tested, 14 of which (21.9%) tested positively with VIA and just 1 (1.6%) tested positive with Pap smear.
As a screening tool for cervical pathology, VIA yielded a sensitivity of 0% and a specificity of 77.78%.
The positive predictive value is 0% and the negative predictive value is 98%. With the use of the
McNemar test, a significant difference is found between VIA and that of Pap smear. Furthermore, the
computed Kappa statistic also indicated a poor agreement between VIA and that of Pap smear results.
Conclusion: Based on the findings of the group, it may be concluded that visual inspection with acetic
acid had lower sensitivity and specificity, and hence is not comparable to Pap smear as a screening test
for cervical pathology.