Under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke (NPCDCS), which of the following is the primary screening modality recommended at the primary health center level for early detection of cervical cancer?

Explanation

## NPCDCS Cervical Cancer Screening Protocol **Key Point:** Visual Inspection with Acetic Acid (VIA) is the WHO-recommended and NPCDCS-endorsed screening test for primary health centers in resource-limited settings like India. ### Rationale for VIA at PHC Level **High-Yield:** VIA is preferred because it is: - **Low-cost** (minimal infrastructure required) - **Real-time results** (no need for laboratory processing) - **High sensitivity and specificity** (85–92% and 85–90% respectively) - **Feasible** in peripheral health centers with minimal training ### Comparison of Cervical Cancer Screening Methods | Method | Setting | Cost | Sensitivity | Specificity | Infrastructure | |--------|---------|------|-------------|-------------|----------------| | VIA | PHC/CHC | Low | 85–92% | 85–90% | Minimal | | Pap smear | CHC/District | Moderate | 60–70% | 95% | Lab required | | HPV DNA | Tertiary | High | 95%+ | 90%+ | Advanced lab | | Colposcopy | Tertiary | High | Variable | Variable | Specialized | **Clinical Pearl:** NPCDCS guidelines recommend a "see-and-treat" approach using VIA at the PHC level, where women with positive VIA are referred for colposcopy and treatment at higher centers, improving accessibility and reducing loss to follow-up. **Mnemonic:** **VIA-PHC** = Visual Inspection with Acetic acid at Primary Health Center (the screening backbone of NPCDCS cervical cancer program). [cite:Park 26e Ch 9]