In the evaluation of a cervical cancer screening programme using VIA (Visual Inspection with Acetic acid), the programme shows high sensitivity but low specificity compared to Pap smear. A major consequence of low specificity in this context is:

• A Unnecessary colposcopy/cryotherapy in women without true precancerous lesions ✓
• B Missed cervical cancer cases leading to late-stage presentation
• C Low negative predictive value requiring frequent re-screening
• D Reduction in cancer-specific mortality without affecting morbidity

Explanation

Low specificity means a high false-positive rate — women without true CIN 2/3 lesions test positive on VIA. In programmes using 'screen-and-treat' strategy, these false positives undergo unnecessary cryotherapy or LEEP, causing physical harm, psychological distress, and wasted resources. Missed cases (option B) result from low sensitivity, not low specificity. Negative predictive value is principally affected by sensitivity and prevalence. VIA's high false-positive burden is a recognized limitation and is why hrHPV testing is being scaled up under the National Programme for Non-Communicable Disease Control.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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