{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T07:17:00Z","timestamp":1776755820606,"version":"3.51.2"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2013,11,30]],"date-time":"2013-11-30T00:00:00Z","timestamp":1385769600000},"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":[[2014,6,15]]},"abstract":"<jats:p>Although virtually all cervical cancers and most cervical intraepithelial neoplasia (CIN) are caused by persistent human papillomavirus (HPV) infection, only a small proportion of HPV\u2010positive women have or will develop CIN. Triaging HPV\u2010positive women has been suggested to reduce the false\u2010positive rate and proportion of women referred for CIN confirmation and\/or treatment. In two cross\u2010sectional studies and one randomized trial in India, we evaluated the impact of using cytology or visual inspection with acetic acid (VIA) to triage HPV\u2010positive women on the proportion of women who would be referred for CIN confirmation and on the detection rates of high\u2010grade CIN. We present the numbers of HPV test\u2010positive women found and the CIN detected among them. We further assess the proportions that would be referred for CIN confirmation with colposcopy\/biopsy and CIN that would be detected if cytology triage or VIA triage were used. Using cytology triage at atypical squamous cells of undetermined significance threshold or VIA triage reduced referrals for colposcopy by about 62% and 59%, respectively (<jats:italic>p<\/jats:italic>\u2010value\u2009=\u20090.012), but missed around 16% and 18%, respectively, of the high\u2010grade CIN (<jats:italic>p<\/jats:italic>\u2010value\u2009=\u20090.539) indicating similar performance of both triaging approaches. The choice of a triage test in different low\u2010 and middle\u2010income countries (LMIC) would depend on the availability and affordability in the particular setting. Cytology triage may be considered in settings where adequate infrastructure exists, whereas VIA triage may be suitable in settings with limited or no cytology infrastructure.<\/jats:p>","DOI":"10.1002\/ijc.28627","type":"journal-article","created":{"date-parts":[[2013,11,25]],"date-time":"2013-11-25T07:11:38Z","timestamp":1385363498000},"page":"2902-2909","source":"Crossref","is-referenced-by-count":29,"title":["Evaluation of cytology and visual triage of human papillomavirus\u2010positive women in cervical cancer prevention in India"],"prefix":"10.1002","volume":"134","author":[{"given":"Richard","family":"Muwonge","sequence":"first","affiliation":[{"name":"Screening Group, Early Detection &amp; Prevention Section International Agency for Research on Cancer Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramani S.","family":"Wesley","sequence":"additional","affiliation":[{"name":"Regional Cancer Centre Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhagwan M.","family":"Nene","sequence":"additional","affiliation":[{"name":"Nargis Dutt Memorial Cancer Hospital Barshi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surendra S.","family":"Shastri","sequence":"additional","affiliation":[{"name":"Department of Preventive Oncology Tata Memorial Center Tata Memorial Hospital &amp; Cancer Research Institute Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kasturi","family":"Jayant","sequence":"additional","affiliation":[{"name":"Nargis Dutt Memorial Cancer Hospital Barshi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylla G.","family":"Malvi","sequence":"additional","affiliation":[{"name":"Nargis Dutt Memorial Cancer Hospital Barshi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somanathan","family":"Thara","sequence":"additional","affiliation":[{"name":"Regional Cancer Centre Trivandrum India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rengaswamy","family":"Sankaranarayanan","sequence":"additional","affiliation":[{"name":"Screening Group, Early Detection &amp; Prevention Section International Agency for Research on Cancer Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.25516"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdr015"},{"key":"e_1_2_7_4_1","volume-title":"GLOBOCAN 2008: Cancer incidence and mortality worldwide: IARC cancer base no. 10 [Internet]","author":"Ferlay J","year":"2010"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2005.01.009"},{"key":"e_1_2_7_6_1","first-page":"954","article-title":"Effective screening programmes for cervical cancer in low\u2010 and middle\u2010income developing countries","volume":"79","author":"Sankaranarayanan R","year":"2001","journal-title":"Bull World Health Organ"},{"key":"e_1_2_7_7_1","volume-title":"IARC handbooks on cancer prevention. 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