## NPCDCS Cervical Cancer Screening Protocol **Key Point:** Visual inspection with acetic acid (VIA) is the recommended screening tool for cervical cancer at the primary health center level under NPCDCS in India. ### Rationale for VIA as First-Line Screening **High-Yield:** VIA is preferred in resource-limited settings because it is: - Low-cost and non-invasive - Does not require laboratory infrastructure - Can be performed by trained health workers at PHC level - Provides immediate results (same-visit screening and treatment possible) - Acceptable to women in rural and semi-urban areas ### NPCDCS Cervical Cancer Screening Algorithm | Screening Tool | Setting | Feasibility | Cost | | --- | --- | --- | --- | | VIA | PHC/Sub-centers | High | Low | | Pap smear | District hospitals/CHCs | Moderate | Moderate | | HPV DNA testing | Tertiary centers | Low | High | | Colposcopy | Tertiary centers (diagnostic) | Low | High | **Clinical Pearl:** Under NPCDCS, women with positive VIA results are referred to district hospitals for colposcopy and biopsy if indicated. This two-tier approach maximizes screening coverage while reserving expensive investigations for confirmed cases. **Mnemonic:** VIA = **V**isual **I**nspection with **A**cetic acid — the bedside screening tool for resource-constrained India. [cite:Park 26e Ch 10]
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