{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:38:13Z","timestamp":1786977493842,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2002,3,15]],"date-time":"2002-03-15T00:00:00Z","timestamp":1016150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2002,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The authors evaluated direct visual inspection of the cervix after the application of 5% acetic acid (DVI) as a cervical cancer screening test for use in low\u2010resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Four tests were used to screen 2754 previously unscreened women: DVI with and without \u00d74.5 magnification and differentiating between all lesions and well\u2010circumscribed lesions; testing for high\u2010risk types of human papillomavirus DNA using the Hybrid Capture II assay, cervical cytology, and Cervicography\u2122. Women with positive results on any of the four screening tests were referred for colposcopy and histologic sampling. All women were tested for N. gonorrhea, C. trachomatis, T. vaginalis, and human immunodeficiency virus 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Histologically confirmed carcinoma was diagnosed in 21 women (0.8%), high\u2010grade squamous intraepithelial lesions (SILs) were diagnosed in 96 women (3.5%), and low\u2010grade SILs were diagnosed in 102 women (3.7%). The estimated sensitivity of DVI when performed without magnification for high\u2010grade SILs was 70%, with an estimated specificity of 79%. Magnification did not significantly improve sensitivity for high\u2010grade SILs (74% with magnification) but significantly reduced specificity (77%). Restricting the definition of a positive DVI test to a well\u2010defined acetowhite lesion reduced sensitivity and significantly improved specificity. Infection with T. vaginalis, N. gonorrhea, and C. trachomatis did not alter sensitivity or specificity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study confirmed the utility of DVI as a primary screening test. Evaluation of the clinical effectiveness of screening with this low\u2010cost and simple test in low\u2010resource settings is necessary. Cancer 2002;94:1699\u2013707. \u00a9 2002 American Cancer Society.<\/jats:p>\n                    <jats:p>DOI 10.1002\/cncr.10381<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.10381","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T19:42:44Z","timestamp":1030304564000},"page":"1699-1707","source":"Crossref","is-referenced-by-count":115,"title":["Direct visual inspection for cervical cancer screening"],"prefix":"10.1002","volume":"94","author":[{"given":"Lynette","family":"Denny","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Kuhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Pollack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Thomas C.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2002,3,15]]},"reference":[{"key":"e_1_2_7_2_2","first-page":"133","volume-title":"Screening for cancer of the uterine cervix","author":"IARC Working Group on Cervical Cancer Screening","year":"1986"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)92695-X"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.293.6548.659"},{"issue":"3","key":"e_1_2_7_5_2","first-page":"403","article-title":"A screening programme for cervical cancer that worked","volume":"17","author":"Hakama M","year":"1988","journal-title":"Cancer Surveys"},{"key":"e_1_2_7_6_2","first-page":"47","volume-title":"Screening for cancer of the uterine cervix","author":"Hakama M","year":"1986"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.196"},{"key":"e_1_2_7_8_2","first-page":"184","volume-title":"Cancer screening","author":"Parkin DM","year":"1991"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910340103"},{"key":"e_1_2_7_10_2","first-page":"519","article-title":"Cancer in developing countries","volume":"20","author":"Parkin DM","year":"1994","journal-title":"Cancer Surveys"},{"key":"e_1_2_7_11_2","first-page":"337","article-title":"Cervical screening attendance and its effectiveness in a rural population in China","volume":"13","author":"Zhang JF","year":"1989","journal-title":"Cancer Detect Prev"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890815)64:4<962::AID-CNCR2820640432>3.0.CO;2-B"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000333907"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/dc.2840100104"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0029-7844(96)00189-5"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19981115)83:10<2150::AID-CNCR13>3.0.CO;2-0"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0215(19990105)80:1<161::AID-IJC28>3.0.CO;2-8"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)07033-0"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000815)89:4<826::AID-CNCR15>3.0.CO;2-5"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.105871"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199301000-00017"},{"key":"e_1_2_7_22_2","first-page":"87","volume-title":"Premalignant lesions of the lower genital tract","author":"Reid R"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a117485"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.24.3107"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.10381","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.10381","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T12:31:47Z","timestamp":1760272307000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.10381"}},"subtitle":["An analysis of factors influencing test performance"],"short-title":[],"issued":{"date-parts":[[2002,3,15]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2002,3,15]]}},"alternative-id":["10.1002\/cncr.10381"],"URL":"https:\/\/doi.org\/10.1002\/cncr.10381","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,3,15]]}}}