Abstract
INTRODUCTION: Cervical cancer remains a major public health issue, particularly in low- and middle-income countries. Early detection through effective screening is crucial. This study aimed to compare the diagnostic accuracy of visual inspection with acetic acid (VIA) and liquid-based cytology (LBC) in detecting cervical neoplasia among asymptomatic women. METHODOLOGY: A cross-sectional study was conducted on 300 asymptomatic women aged 25-65 years. Each participant underwent both VIA and LBC tests. Histopathological examination following colposcopy served as the gold standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS: Histopathology confirmed cervical neoplasia in 42 women (14%). VIA demonstrated higher sensitivity (80.95%) but lower specificity (89.11%) compared to LBC (sensitivity 71.43%, specificity 96.11%). VIA had a higher NPV (96.63%), while LBC had a higher PPV (75.00%). CONCLUSION: VIA is a suitable screening tool in low-resource settings due to its high sensitivity and low cost, while LBC offers higher specificity and diagnostic precision. A tiered or combined approach may enhance overall screening efficiency for cervical neoplasia in asymptomatic populations.