{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:28:50Z","timestamp":1778509730861,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,4,16]],"date-time":"2007-04-16T00:00:00Z","timestamp":1176681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2007,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cervical cancer is an important public health problem in many developing countries, where cytology screening has been ineffective. We compared four tests to identify the most appropriate for screening in countries with limited resources. Nineteen midwives screened 5,435 women with visual inspection (VIA) and collected cervical samples for HPV testing, liquid\u2010based cytology (LBC) and conventional cytology (CC). If VIA was positive, a doctor performed magnified VIA. CC was read locally, LBC was read in Lima and HPV testing was done in London. Women with a positive screening test were offered colposcopy or cryotherapy (with biopsy). Inadequacy rates were 5% and 11% for LBC and CC respectively, and less than 0.1% for VIA and HPV. One thousand eight hundred eighty\u2010one women (84% of 2,236) accepted colposcopy\/cryotherapy: 79 had carcinoma <jats:italic>in situ<\/jats:italic> or cancer (CIS+), 27 had severe\u2010 and 42 moderate\u2010dysplasia on histology. We estimated a further 6.5 cases of CIS+ in women without a biopsy. Sensitivity for CIS+ (specificity for less than moderate dysplasia) was 41.2% (76.7%) for VIA, 95.8% (89.3%) for HPV, 80.3% (83.7%) for LBC, and 42.5% (98.7%) for CC. Sensitivities for moderate dysplasia or worse were better for VIA (54.9%) and less favourable for HPV and cytology. In this setting, VIA and CC missed the majority of high\u2010grade disease. Overall, HPV testing performed best. VIA gives immediate results, but will require investment in regular training and supervision. Further work is needed to determine whether screened\u2010positive women should all be treated or triaged with a more specific test. \u00a9 2007 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ijc.22757","type":"journal-article","created":{"date-parts":[[2007,4,16]],"date-time":"2007-04-16T18:18:17Z","timestamp":1176747497000},"page":"796-802","source":"Crossref","is-referenced-by-count":84,"title":["Cervical screening by visual inspection, HPV testing, liquid\u2010based and conventional cytology in Amazonian Peru"],"prefix":"10.1002","volume":"121","author":[{"given":"Maribel","family":"Almonte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catterina","family":"Ferreccio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Winkler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Cuzick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivien","family":"Tsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Robles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rina","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Sasieni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,4,16]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(01)00267-2"},{"key":"e_1_2_7_3_2","first-page":"1","volume-title":"Screening for cancer of the uterine cervix","author":"IARC Working Group on Cervical Cancer Screening, The UICC Project Group on the Evaluation of Screening Programmes for Cancer","year":"1986"},{"key":"e_1_2_7_4_2","first-page":"403","article-title":"A screening programme for cervical cancer that worked","volume":"7","author":"Hakama M","year":"1988","journal-title":"Cancer Surv"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.196"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cdp.2003.09.004"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0188-0128(99)00006-8"},{"key":"e_1_2_7_8_2","volume-title":"IARC handbooks of cancer prevention, vol. 10: Cervix cancer screening","author":"IARC.","year":"2005"},{"key":"e_1_2_7_9_2","first-page":"411","volume-title":"New developments in cervical cancer screening and prevention","author":"Sankaranarayanana B","year":"1997"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(01)01454-5"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)07033-0"},{"key":"e_1_2_7_12_2","first-page":"351","article-title":"Early detection of cervical cancer through acetic acid application\u2014an aided visual inspection","volume":"42","author":"Singh V","year":"2001","journal-title":"Singapore Med J"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20190"},{"key":"e_1_2_7_14_2","volume-title":"Per\u00fa en Mapas: Atlas en base al Censo de Poblaci\u00f3n y Vivienda. 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