{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T16:24:04Z","timestamp":1788539044596,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T00:00:00Z","timestamp":1663804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011054","name":"Danish International Development Agency","doi-asserted-by":"publisher","award":["14\u2010TAN\u2010P02"],"award-info":[{"award-number":["14\u2010TAN\u2010P02"]}],"id":[{"id":"10.13039\/501100011054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008363","name":"Kr\u00e6ftens Bek\u00e6mpelse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008363","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001734","name":"K\u00f8benhavns Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001734","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2023,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cervical cancer is the most common female cancer in Eastern Africa, and the World Health Organization (WHO) recommends human papillomavirus (HPV)\u2010based screening as a key element to eliminate the disease. In this cross\u2010sectional study from Tanzania, we compared nine HPV\u2010based cervical cancer screening strategies, including HPV testing at standard cut\u2010off; HPV testing at increased viral load cut\u2010offs; HPV testing with partial\/extended genotyping, and HPV testing with visual inspection with acetic acid (VIA). We pooled data collected during 2008 to 2009 and 2015 to 2017 from 6851 women aged 25 to 65. Cervical cytology samples were HPV tested with Hybrid Capture 2, and HPV positive samples were genotyped with INNO\u2010LiPA Extra II. Human immunodeficiency virus (HIV) testing and VIA were done according to local standards. We calculated sensitivity, specificity, positive and negative predictive value of screening strategies, with high\u2010grade cytological lesions as reference, separately for women with and without HIV. HPV testing at standard cut\u2010off (1.0 relative light units [RLU]) had highest sensitivity (HIV+: 97.8%; HIV\u2212: 91.5%), but moderate specificity (HIV+: 68.1%; HIV\u2212: 85.7%). Increasing the cut\u2010off for HPV positivity to higher viral loads (5.0\/10.0 RLU) increased specificity (HIV+: 74.2%\u201076.5%; HIV\u2212: 89.5%\u201091.2%), with modest sensitivity reductions (HIV+: 91.3%\u201095.7%; HIV\u2212: 83.5%\u201087.8%). Limiting test positivity to HPV types 16\/18\/31\/33\/35\/45\/52\/58 improved specificity while maintaining high sensitivity (HIV+: 90.2%; HIV\u2212: 81.1%). Triage with VIA and\/or partial genotyping for HPV16\/18 or HPV16\/18\/45 had low sensitivities (\u226465%). In conclusion, HPV testing alone, or HPV testing with extended genotyping or increased viral load cut\u2010offs, may improve cervical cancer screening in Sub\u2010Saharan Africa.<\/jats:p>","DOI":"10.1002\/ijc.34283","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T07:50:56Z","timestamp":1662969056000},"page":"686-696","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Comparison of human papillomavirus\u2010based cervical cancer screening strategies in Tanzania among women with and without <scp>HIV<\/scp>"],"prefix":"10.1002","volume":"152","author":[{"given":"Crispin","family":"Kahesa","sequence":"first","affiliation":[{"name":"Department of Cancer Prevention Services Ocean Road Cancer Institute  Dar es Salaam United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0738-8410","authenticated-orcid":false,"given":"Louise T.","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Unit of Virus, Lifestyle and Genes Danish Cancer Society Research Center  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0851-6760","authenticated-orcid":false,"given":"Ditte S.","family":"Linde","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Southern Denmark  Odense Denmark"},{"name":"Department of Gynecology and Obstetrics Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4788-8660","authenticated-orcid":false,"given":"Bariki","family":"Mchome","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Center  Moshi United Republic of Tanzania"},{"name":"Kilimanjaro Christian Medical University College  Moshi United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1021-2280","authenticated-orcid":false,"given":"Johnson","family":"Katanga","sequence":"additional","affiliation":[{"name":"Department of Cancer Prevention Services Ocean Road Cancer Institute  Dar es Salaam United Republic of Tanzania"},{"name":"Department of Clinical Oncology Muhimbili University of Health and Allied Sciences  Dar es Salaam United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2272-8743","authenticated-orcid":false,"given":"Patricia","family":"Swai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Kilimanjaro Christian Medical Center  Moshi United Republic of Tanzania"},{"name":"Kilimanjaro Christian Medical University College  Moshi United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3841-974X","authenticated-orcid":false,"given":"Rachel","family":"Manongi","sequence":"additional","affiliation":[{"name":"Institute of Public Health Kilimanjaro Christian Medical University College  Moshi United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3462-6541","authenticated-orcid":false,"given":"Myassa","family":"Kjaerem","sequence":"additional","affiliation":[{"name":"Department of Medical Affairs and Scientific Communication AJ Vaccines A\/S  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5929-7078","authenticated-orcid":false,"given":"Thomas","family":"Iftner","sequence":"additional","affiliation":[{"name":"Institute of Medical Virology University Hospital of T\u00fcbingen  T\u00fcbingen 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