{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:04:47Z","timestamp":1767589487457,"version":"3.48.0"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID\u2010OAA\u2010A\u201011\u2010 00012"],"award-info":[{"award-number":["AID\u2010OAA\u2010A\u201011\u2010 00012"]}],"id":[{"id":"10.13039\/100000200","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":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Human papillomavirus (HPV) testing is now recommended for primary screening for invasive cervical cancer (ICC) among women. We evaluated same\u2010day completion of an HPV screen\u2010triage\u2010treat algorithm consisting of: (1) GeneXpert high\u2010risk HPV testing of self\u2010collected vaginal samples, (2) visual inspection with acetic acid (VIA) and colposcopy for HPV+ women, and (3) thermal ablation (TA) treatment for HPV+ women with acetowhite cervical lesions eligible for TA by colposcopy, in Lilongwe, Malawi. We calculated same\u2010day completion rates of the screening algorithm as the proportion of: (a) HPV+ women who had VIA the same day, and (b) HPV+ women with ablation\u2010eligible lesions by colposcopy who received TA the same day. Between June 2020 and February 2022, we enrolled 1250 participants: 625 women living with HIV (WLWH) and 625 without HIV. Participant median age was 35\u2009years (IQR 30\u201340). A total of 698 (55.8%) had no prior ICC screening, and 589 (99.7%) of WLWH were on antiretroviral therapy. HPV DNA positivity overall was 38.1% (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009476) and higher among WLWH (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009295, 47.2%) than those without HIV (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009181, 29.0%). Overall, 469 (98.5%) of the 476 HPV+ women had VIA performed. Most HPV+ women had VIA performed the same day (96%, 95% confidence interval [CI]: 94%, 98%). Similarly, most HPV+ women with ablation\u2010eligible lesions by colposcopy received TA the same day (99%, 95% CI: 95%, 100%). VIA performed similarly to colposcopy in eligibility determination for TA. A single visit approach is achievable with an Xpert\u2010based screen\u2010triage\u2010treat strategy for ICC prevention in Malawi, a reassuring finding for HPV\u2010based primary screening scale\u2010up.\n                  <\/jats:p>","DOI":"10.1002\/ijc.70177","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T13:30:17Z","timestamp":1760621417000},"page":"1323-1335","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Single visit screen\u2010triage\u2010treat strategy using\n                    <scp>GeneXpert<\/scp>\n                    \u2010based\n                    <scp>HPV<\/scp>\n                    testing of self\u2010collected cervicovaginal samples and thermal ablation treatment for cervical cancer prevention among women in Lilongwe, Malawi"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-4207","authenticated-orcid":false,"given":"Lameck","family":"Chinula","sequence":"first","affiliation":[{"name":"University of North Carolina Project\u2010Malawi  Lilongwe Malawi"},{"name":"Department of Obstetrics and Gynecology's Division of Global Women's Health University of North Carolina  Chapel Hill North Carolina USA"},{"name":"Department of Obstetrics and Gynecology Kamuzu University of Health Sciences  Blantyre Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maganizo B.","family":"Chagomerana","sequence":"additional","affiliation":[{"name":"University of North Carolina Project\u2010Malawi  Lilongwe Malawi"},{"name":"Department of Medicine University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tawonga","family":"Mkochi","sequence":"additional","affiliation":[{"name":"University of North 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor","family":"Mwapasa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics Kamuzu University of Health Sciences  Blantyre Malawi"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer H.","family":"Tang","sequence":"additional","affiliation":[{"name":"University of North Carolina Project\u2010Malawi  Lilongwe Malawi"},{"name":"Department of Obstetrics and Gynecology's Division of Global Women's Health University of North Carolina  Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"volume-title":"Comprehensive Cervical Cancer 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A demonstration project in six African countries: Malawi Madagascar Nigeria Uganda the United Republic of Tanzania and Za. International Agency for Research on Cancer [Internet]2012;33 Available from:http:\/\/www.who.int\/reproductivehealth\/publications\/cancers\/9789241503860\/en\/"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-15-00325"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12707-9"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3530-y"},{"key":"e_1_2_12_11_1","unstructured":"The Government of Malawi Ministry of Health.Cervical Cancer Strategic Plan."},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2015.21.231.6350"},{"key":"e_1_2_12_13_1","first-page":"1","volume":"1","author":"Maseko FC","year":"2015","journal-title":"Glob Health Action"},{"volume-title":"WHO Guideline for Screening and Treatment of Cervical Pre\u2010Cancer Lesions for Cervical Cancer Prevention","year":"2021","author":"World Health Organisation","key":"e_1_2_12_14_1"},{"key":"e_1_2_12_15_1","unstructured":"WHO.Global strategy to accelerate the elimination of cervical cancer as a public health problem.2020."},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00176-14"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pvr.2015.05.002"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2018-001351"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.4314\/mmj.v30i2.2"},{"key":"e_1_2_12_20_1","unstructured":"National Service Delivery Guidelines for Cervical Cancer Prevention and Control.2019."},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30101"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2016.11.014"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2022.100903"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000681"},{"key":"e_1_2_12_25_1","unstructured":"SankaranarayananR WealeyR.A practical manual on visual screening for cervical neoplasia a practical manual on visual screening for cervical neoplasia a practical manual on visual screening for cervical neoplasia. 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