Cytology versus visual inspection with acetic acid among women treated previously with cryotherapy in a low-resource setting

Miriam Cremer, Kimberley Bullard, Mauricio Maza, Ethel Peralta, Elizabeth Moore, Lydia Garcia, Rachel Masch, Veronica Lerner, Todd A. Alonzo, Juan Felix

Research output: Contribution to journalArticle

14 Scopus citations


Objective: To compare visual inspection with acetic acid (VIA) with conventional cervical cytology as a follow-up cervical cancer screening method in women who had been treated previously with cryotherapy. Methods: Salvadoran women screened with VIA and treated with cryotherapy within 3 years were eligible to participate. Study participants were rescreened with VIA, Pap smear, colposcopy, 4-quandrant biopsy, and endocervical curettage. Results: Of 147 women enrolled in the study, post-cryotherapy VIA was positive in 39 women (26.5%; 95% CI, 19.6%-34.4%). Of these 39, 1 woman had CIN 1 or higher on biopsy. Post-cryotherapy Pap smear was positive (ASCUS or higher) in 6 women (4.1%; 95% CI, 1.5%-8.7%). Of these 6, 2 women had CIN 1 or higher on biopsy. Post-cryotherapy specificity was significantly higher for Pap compared with VIA (95.8% [138/144]; 95% CI, 91.2%-98.5% vs 73.6% [106/144]; 95% CI, 65.6%-80.6%; P < 0.001). Conclusion: As the single-visit approach for cervical cancer screening gains popularity, more women will have been treated with cryotherapy. Appropriate follow-up screening is therefore vital. Cytology may be a more suitable screening method than VIA in low-resource settings for women treated previously with cryotherapy.

Original languageEnglish (US)
Pages (from-to)249-252
Number of pages4
JournalInternational Journal of Gynecology and Obstetrics
Issue number3
Publication statusPublished - Dec 2010



  • Cryotherapy
  • Cytology
  • El Salvador
  • Follow-up screening
  • Low-resource setting
  • VIA
  • Visual inspection with ascetic acid

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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