{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T03:58:35Z","timestamp":1778731115995,"version":"3.51.4"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T00:00:00Z","timestamp":1528416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008778","name":"Florida Atlantic University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008778","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cervical cancer remains the leading cause of cancer and mortality in low\u2010resource areas with healthcare personnel shortages. Visual inspection is a low\u2010resource alternative method of cervical cancer screening in areas with limited access to healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess accuracy of visual inspection performed by community health workers (<jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content>s) and licensed providers, and the effect of provider training on visual inspection accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Five databases and four websites were queried for studies published in English up to December 31, 2015. Derivations of \u201ccervical cancer screening\u201d and \u201cvisual inspection\u201d were search terms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Visual inspection screening studies with provider definitions, colposcopy reference standards, and accuracy data were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>A priori variables were extracted by two independent reviewers. Bivariate linear mixed\u2010effects models were used to compare visual inspection accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Provider type was a significant predictor of visual inspection sensitivity (<jats:italic>P<\/jats:italic>=0.048); sensitivity was 15 percentage points higher among <jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content>s than physicians (<jats:italic>P<\/jats:italic>=0.014). Components of provider training were significant predictors of sensitivity and specificity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Community\u2010based visual inspection programs using adequately trained <jats:styled-content style=\"fixed-case\">CHW<\/jats:styled-content>s could reduce barriers and expand access to screening, thereby decreasing cervical cancer incidence and mortality for women at highest risk and those living in remote areas with limited access to healthcare personnel.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.12535","type":"journal-article","created":{"date-parts":[[2018,5,22]],"date-time":"2018-05-22T22:55:20Z","timestamp":1527029720000},"page":"260-269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Accuracy of visual inspection performed by community health workers in cervical cancer screening"],"prefix":"10.1002","volume":"142","author":[{"given":"Susan D.","family":"Driscoll","sequence":"first","affiliation":[{"name":"School of Nursing and Dental Hygiene University of Hawai\u02bbi at M\u0101noa  Honolulu HI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth M.","family":"Tappen","sequence":"additional","affiliation":[{"name":"Christine E. Lynn College of Nursing Florida Atlantic University  Boca Raton FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Newman","sequence":"additional","affiliation":[{"name":"Christine E. Lynn College of Nursing Florida Atlantic University  Boca Raton FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathi","family":"Voege\u2010Harvey","sequence":"additional","affiliation":[{"name":"Christine E. Lynn College of Nursing Florida Atlantic University  Boca Raton FL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,8]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"BruniL Barrionuevo\u2010RosasL AlberoG et\u00a0al.ICO Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Disease in the World. Summary Report 27 July2017.http:\/\/www.hpvcentre.net\/statistics\/reports\/XWX.pdf. 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