Comparison of the efficacy of 5% versus 8% acetic acid concentrations for detecting premalignant and malignant lesions in colposcopy

• Published in: Medicine (Baltimore) Vol. 102; no. 50; p. e36341
• Main Authors: Yilmaz, Alpay, Gulbahar, Aysegul, Sen, Serhat
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 15.12.2023
• Subjects: Acetic Acid; Colposcopy; Early Detection of Cancer; Female; Humans; Observational Study; Papillomaviridae - genetics; Papillomavirus Infections - diagnosis; Precancerous Conditions - diagnosis; Pregnancy; Retrospective Studies; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms - pathology; Vaginal Smears
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000036341

Although preventable; cervical cancer remains a significant cause of morbidity and mortality worldwide, especially in developing countries; thus, early diagnosis and treatment are essential to prevent its development into invasive cancer. Based on the screening results, diagnostic colposcopy was performed to evaluate women with abnormal Papinocalaou test results, high-risk human papillomavirus DNA positivity, or suspected cervical cancer. Therefore, this study aimed to determine the optimal acetic acid concentration (5% or 8%) for detecting cervical precancerous/cancerous lesions during colposcopy evaluation. This study included 607 patients admitted to our obstetrics and gynecology clinic. The medical records of the patients were obtained from the colposcopy registry in the hospital information system and retrospectively analyzed. The cases were divided into 2 groups according to the acetic acid concentrations (5% and 8%) used during colposcopy and examined. The duration of acetic acid application was 2 to 4 minutes. The probability of developing ≥ CIN2 was low in patients with negative for intraepithelial lesion or malignancy smear results in both groups, but increased in the high-grade squamous intraepithelial lesions/atypical squamous cells group with the 8% acetic acid concentration (P < .0001; P = .012). The probabilities of pathological detection of ≥ CIN2 in the 5% and 8% acetic acid groups were 17.3% and 46.6%, respectively (P < .0001). The enhancement of the efficiency of colposcopy should focus on improving the detectability of precancerous lesions. Given that this study compared the effectiveness of acetic acid concentration in colposcopy diagnostics, it can be considered a leading study in this field.