{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T02:27:18Z","timestamp":1776738438018,"version":"3.51.2"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,12,3]],"date-time":"2013-12-03T00:00:00Z","timestamp":1386028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2014,6,15]]},"abstract":"<jats:p>Using human papillomavirus (HPV) testing for cervical cancer screening in lower\u2010resource settings (LRS) will result in a significant number of screen\u2010positive women. This analysis compares different triage strategies for detecting cervical precancer and cancer among HPV\u2010positive women in LRS. This was a population\u2010based study of women aged 25\u201365 years living in China (<jats:italic>n<\/jats:italic>\u2009=\u20097,541). Each woman provided a self\u2010collected and two clinician\u2010collected specimens. The self\u2010collected and one clinician\u2010collected specimen were tested by two HPV DNA tests\u2014<jats:italic>care<\/jats:italic>HPV\u2122 and Hybrid Capture 2; the other clinician\u2010collected specimen was tested for HPV16\/18\/45 E6 protein. C<jats:italic>are<\/jats:italic>HPV\u2122\u2010positive specimens were tested for HPV16\/18\/45 DNA. HPV DNA\u2010positive women underwent visual inspection with acetic acid (VIA) and then colposcopic evaluation with biopsies. The performance for detection of cervical intraepithelial neoplasia grade 3 or cancer (CIN3+) among HPV DNA\u2010positive women was assessed for different triage strategies: HPV16\/18\/45 E6 or DNA detection, VIA, colposcopic impression, or higher signal strength (\u226510 relative light units\/positive control [rlu\/pc]). The percent triage positive ranges were 14.8\u201317.4% for VIA, 17.8\u201320.9% for an abnormal colposcopic impression; 7.9\u201310.5% for HPV16\/18\/45 E6; 23.4\u201328.4% for HPV16\/18\/45 DNA; and 48.0\u201362.6% for higher signal strength (\u226510 rlu\/pc), depending on the HPV test\/specimen combination. The positivity for all triage tests increased with severity of diagnosis. HPV16\/18\/45 DNA detection was approximately 70% sensitive and had positive predictive values (PPV) of approximately 25% for CIN3+. HPV16\/18\/45 E6 detection was approximately 50% sensitive with a PPV of nearly 50% for CIN3+. Different triage strategies for HPV DNA\u2010positive women provide important tradeoffs in colposcopy or treatment referral percentages and sensitivity for prevalent CIN3+.<\/jats:p>","DOI":"10.1002\/ijc.28616","type":"journal-article","created":{"date-parts":[[2013,11,19]],"date-time":"2013-11-19T05:08:16Z","timestamp":1384837696000},"page":"2891-2901","source":"Crossref","is-referenced-by-count":80,"title":["Lower cost strategies for triage of human papillomavirus DNA\u2010positive women"],"prefix":"10.1002","volume":"134","author":[{"given":"You\u2010Lin","family":"Qiao","sequence":"first","affiliation":[{"name":"Cancer Institute and Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Jeronimo","sequence":"additional","affiliation":[{"name":"PATH 2201 Westlake Avenue, Suite 200 Seattle 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