Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

Every VIA examination should end with the provider making a decision about further management. The most common use of VIA is in a screen-and-treat setting, where the VIA-positive women are treated without any further verification of disease by colposcopy or histopathology. This is also applicable in settings where VIA is used to triage HPV-positive women.

When the HPV test is used as the primary screening test in a screen-and-treat setting, the HPV-positive women are treated without colposcopic or histopathological verification. The choice of treatment (ablation or excision) depends on certain features of the cervix that can be visualized only during examination after application of acetic acid for 1 minute.

Hence, determination of eligibility for ablative treatment, irrespective of whether VIA or the HPV test is used to screen women, is dependent on the changes observed after application of acetic acid. The physiological and pathological principles, the equipment and consumables required, and the steps of the examination to determine eligibility for ablation are exactly the same as those for VIA.

The next section discusses the most commonly used techniques for treating cervical precancers. This is followed by the selection criteria for different types of treatment and the steps to determine eligibility for ablative treatment.