ORIGINAL RESEARCH article
Front. Glob. Women’s Health
Sec. Quality of Life
Visual inspection with acetic acid (VIA) and Colposcopy: screening of cervical cancer in resource-limited healthcare settings
Provisionally accepted
Hasin Anupama Azhari1Masum Chawdhury2
Farzana Islam3Golam Abu Zakaria4
Koustuv Dalal5*
Hasan Mahmud Reza6- 1United International University, Dhaka, Bangladesh
- 2Alo Bhubon Trust (Alo-BT), Dhaka, Bangladesh
- 3Alo Bhubon Trust (Alo -BT), Dhaka, Bangladesh
- 4Hochschule Anhalt, Köthen, Germany
- 5Mid Sweden University, Sundsvall, Sweden
- 6North South University, Dhaka, Bangladesh
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Background: This study was conducted to assess the effectiveness of visual inspection with acetic acid (VIA) followed by colposcopy for cervical cancer screening. Like many low-and middle-income countries (LMICs), Bangladesh is also struggling with inadequate cervical cancer screening and diagnostic facilities as well as cytopathologists and histopathologists in remote rural areas. Human papillomavirus (HPV) testing has not yet been implemented effectively in Bangladesh, and cytology (Pap smear) is a costly procedure. The current study conducted VIA and colposcopy on apparently healthy adult women, primarily to screen for cervical lesions and, secondarily, to identify risk factors. Methods: This cross-sectional study was conducted using a straightforward and affordable VIA followed by colposcopy in a remote rural health center in Bangladesh. This facility-based, cross-sectional study was piloted among 384 married women aged between 18 to 65 years following field-level awareness on prevention of cervical cancer. Results: Out of 384 women tested, 247 (64.3%) were adult women, 85 (22.1%) were middle-aged, 33 (8.6%) were older, and only 19 (4.9%) were young adults. The study revealed that more than one-third of the participants (39.1%) were engaged in sexual activities without using condoms. A total of 20 participants were found VIA-positive (5.2%). Among the VIA-positive cases, 60% were confirmed by colposcopy. The chi-square test showed multiple sexual exposures without condoms to be a significant risk factor for developing cervical cancer. All double-positive cases (n=12) received treatment; 7 (58.3%) underwent thermocoagulation (heat-based ablation) and 5 (41.7%) received Loop Electrosurgical Excision Procedure (LEEP), a method of removing abnormal tissue, at referral hospitals. Conclusion: We propose that in order to achieve Sustainable Development Goals (SDG) 3.7 and 3.8, VIA-colposcopy is suitable for screening cervical cancer in rural areas of Bangladesh and other LMICs, where screening techniques such as Pap smear and HPV tests are not yet available and accessible.
Keywords: Colposcopy, cervical cancer, VIA, screening, Bangladesh
Received: 12 Aug 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Azhari, Chawdhury, Islam, Zakaria, Dalal and Reza. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Koustuv Dalal
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