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Pap smears more effective than VIA in testing for cervical cancer – Oncologist
As part of the fight against cervical cancer, a campaign had long ensued by the Public Health Ministry to encourage women to be screened with a view to advancing early detection and early treatment. This is in light of the fact that once detected and treated at an early stage, cancer can be eliminated altogether.
Among the screening measures that the public health sector has been promoting is that of the Visual Inspection with Acetic Acid [VIA]. The VIA screening programme has been catching on countrywide and has even been regarded as successful, since an increasing number of women have been accessing the service free of cost at many public health and even private health facilities.
But according to Consultant Oncologist and Medical Director at the Guyana Cancer Institute, Dr. Sayan Chakraborty, while the VIA screening method has enabled health sectors throughout the world to conduct successful screening programmes, utilising the Pap smear process is by far a more meticulous choice.
He noted that while both screening processes can help to detect for cervical cancer, the basic difference lies in the way each is carried out. In the case of the VIA test, he explained that “we are putting some acetic acid on the cervix and we are noting the colour change…it is an effective process of screening, true, and it is used at many places and in many countries.”
But in the case of the Pap smear, Dr. Chakraborty noted, this screening process actually takes scrapings from the cervix and vagina and these are closely examined.
“It is just like putting a swab in the cervix and taking the secretions and putting it on a slide and looking at it under a microscope,” explained Dr. Chakraborty.
In fact, he informed that the Pap smear is more specific in finding pre-cancerous or cancerous lesions. This he attributed to the fact that it is examined under a microscope, thereby allowing the medical practitioner to have a better understanding of the sample being examined.
According to the Consultant Oncologist, the use of VIA as the more popular screening method for cervical cancer can be easily linked to the fact that it works well for resource intensive settings.
“Yes, VIA is less costly than Pap Smear…” but he underscored that it is also important to ascertain the most advantageous process before a decision is made.
Dr. Sayan Chakraborty, Consultant Oncologist
“We have to understand that the cervix contains two parts – a part we can see from outside, and there is a canal which is called the endocervical canal; it cannot be seen from outside. So in a VIA we can only see that part of the cervix which is seen from outside, but if there is any cancer present which is growing inside the cervical canal, which is again very common, we are not able to see that, because that canal cannot be seen from outside,” Dr. Chakraborty stated.
This therefore means, he said, that with a Pap smear, “we can take smears or scrapings from the cervix, vagina and also from the endocervical canal. So any cancer involving this part of the vagina, outer part of the cervix or even the endocervical canal can be effectively [detected] by the Pap smear…”
For this very reason, Dr. Chakraborty is of the conviction that the Pap smear test far outweighs that of the VIA test.
“By and large, if you ask me which is the most effective screening test, of course I would be endorsing the Pap smear a little bit more than VIA,” he said.
For this entire month, the Guyana Cancer Institute is offering free cancer screening to women as part of its efforts to commemorate Cervical Cancer Awareness Month. The Institute has also joined a movement to end cervical cancer by 2025 which comes as part of its membership in the Healthy Caribbean Coalition which has been pushing for the elimination of cervical cancer.
The Cancer Institute has also been the beneficiary of a grant from the Government of Australia which has been helping it to screen almost 1,000 women annually, at no cost.
“We are offering urban women the luxury of having a free Pap smear,” said Outreach Director of the Cancer Institute, Dr. Syed Ghazi. He noted that while for the majority of women VIA is more practical, the Pap smear is in fact the gold test.
“Like we have the mammogram as the gold test for [screening] for breast cancer, the Pap smear is the gold test for screening for cervical cancer,” said Dr. Ghazi, as he added, “We are part of the system, but we have our own resources, and we try to give state-of-the-art medical facilities and treatment to our patients.”
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