Interpretation of VIA Ė Suspicious of invasive cancer
The following observations after application of acetic acid are reported as suspicious of invasive cancer:
Thick, dense large acetowhite area: Cervical cancers can present as dense acetowhite areas, often raised from the surface and occupying a large area on the surface of the cervix. The lesion may bleed easily on contact.
Irregular surface: Surface irregularity of the acetowhite area, with or without contact bleeding, is suggestive of cervical cancer.
Obvious growth: The presence of a frank growth on the cervix indicates cervical cancer.
Necrosis: A necrotic or ulcerated area on the cervix is suspicious of invasive cervical cancer. Dense acetowhite areas may be visible wherever the cervical epithelium is intact.
Ulceration: The entire cervix may be replaced by an ulcerated area, with or without contact bleeding.
Note: Invasive cancer may not turn white after application of acetic acid, because the entire surface epithelium may be peeled off as a result of the underlying growth.