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In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV\u2010positive women was evaluated. Women aged 30\u201064\u2009years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study\u2010trained midwives\/nurses\/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty\u2010two HPV\u2010positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2\u201089.5) among women &lt;50\u2009years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9\u201086.6). Overall specificity was 58.6% (95% CI 56.7\u201060.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8\u201073.5) compared to women &lt;50 (54.3%, 95% CI 52.1\u201056.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9\u201038.6) compared to women &lt;50 (53.2, 95% CI 51.1\u201055.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%\u201095.4%, 44.9%\u201094.4%, 8.2%\u201065.3%, 0%\u201098.7%, respectively). VIA sensitivity for cervical precancer detection among HPV\u2010positive women performed by trained providers was high with an important reduction in referral rates. However, scaling\u2010up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.<\/jats:p>","DOI":"10.1002\/ijc.34384","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T07:16:19Z","timestamp":1669878979000},"page":"1581-1592","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Performance of visual inspection of the cervix with acetic acid (\n                    <scp>VIA<\/scp>\n                    ) for triage of\n                    <scp>HPV<\/scp>\n                    screen\u2010positive women: results from the\n                    <scp>ESTAMPA<\/scp>\n                    study"],"prefix":"10.1002","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8717-6911","authenticated-orcid":false,"given":"Armando","family":"Baena","sequence":"first","affiliation":[{"name":"International Agency for Research on Cancer  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mesher","sequence":"additional","affiliation":[{"name":"International Agency for Research on Cancer  Lyon France"},{"name":"Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service UK Health Security Agency  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuli","family":"Salgado","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cancerolog\u00eda  Bogot\u00e1 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