Visual inspection after application of acetic acid (VIA) Ė VIA as a screening test for cervical cancer
Visual inspection after application of acetic acid (VIA) involves naked-eye examination of the uterine cervix with appropriate illumination after application of freshly prepared 3Ė5% acetic acid. The interpretation of the test is based on the detection of a well-defined dense acetowhite area on the transformation zone of the cervix 1 minute after application of acetic acid. VIA is a screening test that aims to detect precursor lesions of cervical cancer and early cervical cancers in apparently normal and asymptomatic women. The test is most suitable for women aged 30Ė49 years, because most of the high-grade precancers of the cervix are detected in this age range and the test sensitivity decreases in postmenopausal women. The test is suitable for screening women living with HIV, in whom screening should start at an earlier age.
Following the recommendation of the World Health Organization (published in 2013), VIA is widely used as a screening test in several low- and middle-income countries, both in programmes supported by the government and in opportunistic settings. Nurses, midwives, and general practitioners generally perform the test in primary health-care settings.
The next section describes the advantages of VIA.