{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T20:38:24Z","timestamp":1788899904256,"version":"build-2803163510"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Limited evidence supports the performance of human papillomavirus (HPV) DNA testing as a primary screening method, followed by triage with visual inspection with acetic acid, in areas with limited health care resources, as suggested by the 2021 World Health Organization guidelines.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the performance of visual inspection with acetic acid and Lugol iodine as a triage method for detecting cervical precancerous lesions among HPV-positive women in 1 visit.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study examined the implementation of a government-led cervical cancer screening program conducted from January 1, 2016, to December 31, 2020, in Ordos City, China. Female residents, aged 35 to 64 years, who understood the screening procedures and voluntarily participated were included in the study. Women were excluded if they reported never having had sexual intercourse, were pregnant, had a hysterectomy, or had ever undergone treatment for cervical lesions. Statistical analysis was conducted from December 2022 to December 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n The program used the careHPV DNA assay as the primary screening method, and immediate triage was performed by visual inspection if HPV screening results were positive, with a 5-year screening interval. A colposcopy was performed for the women who had suspected cancer on visual inspection results or who were HPV positive and had abnormal visual inspection results, all in 1 visit.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The rate of compliance with colposcopy and the detection rate of cervical intraepithelial neoplasia grade 2 or higher (CIN2+).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The study included 187\u202f863 women (median age, 46 years [IQR, 40-52 years]) who participated in the program and had valid HPV test results. The overall prevalence of HPV positivity was 12.8% (24\u202f070 of 187\u202f863), and the adherence to triage with visual inspection among HPV-positive women was 93.9% (22\u202f592 of 24\u202f070). Among HPV-positive women, the rate of compliance with colposcopy was 65.6% (2714 of 4137), and the CIN2+ detection rate was 2.8% (643 of 22\u202f592).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this cohort study suggest that the implementation of HPV testing, visual inspection, and colposcopy within 1 visit may mitigate losses to follow-up, detect precancerous lesions, and hold significant implications for screening in comparable areas with limited health care resources.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.4090","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T11:31:24Z","timestamp":1711711884000},"page":"e244090","source":"Crossref","is-referenced-by-count":14,"title":["Cervical Cancer Screening via Visual Inspection With Acetic Acid and Lugol Iodine for Triage of HPV-Positive Women"],"prefix":"10.1001","volume":"7","author":[{"given":"Sumeng","family":"Wang","sequence":"first","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Dang","sequence":"additional","affiliation":[{"name":"Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujun","family":"Liu","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remila","family":"Rezhake","sequence":"additional","affiliation":[{"name":"Cancer Research Institute, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijiao","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianzhi","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le","family":"Zhang","sequence":"additional","affiliation":[{"name":"Dean\u2019s Office, Ordos Maternal and Child Health Care Hospital, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linlin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Department, Ikinholo Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Department, Otog Front Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meili","family":"Su","sequence":"additional","affiliation":[{"name":"Dean\u2019s Office, Dalad Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumei","family":"Guo","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Department, Jungar Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cailing","family":"Yan","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Department, Otog Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meili","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hangjin Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Cao","sequence":"additional","affiliation":[{"name":"Women\u2019s Health Department, Uxin Banner Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dongsheng District Maternal and Child Care Center, Ordos City, Inner Mongolia Autonomous Region, Ordos, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youlin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Global Health, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanghui","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 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