{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:22:04Z","timestamp":1792293724132,"version":"4.4.0"},"reference-count":38,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011054","name":"Danish international development agency","doi-asserted-by":"crossref","award":["14-P02-Tan\/A26775"],"award-info":[{"award-number":["14-P02-Tan\/A26775"]}],"id":[{"id":"10.13039\/501100011054","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,7,16]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Cervical cancer is a major cause of death among women in Eastern Africa, and the distribution of human papillomavirus (HPV) according to HIV status is inadequately characterised in this region. In order to guide future cervical cancer preventive strategies that involve HPV testing, the Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study was established in 2015. The CONCEPT cohort aims to investigate the natural history of HPV and determine acquisition and persistence patterns of high-risk (HR) HPV among HIV-positive and HIV-negative women. Further, the influence of lifestyle and sexual\/reproductive factors will be investigated. The main objective of this article is to describe how the CONCEPT cohort was established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Women aged 25\u201360 years were enrolled from cervical cancer screening clinics in Dar-es-Salaam and Moshi, Tanzania. Data were collected at baseline, at 14 months (first follow-up) and at 28 months (second follow-up). Biological samples included two cervical swabs for\n                      <jats:italic>care<\/jats:italic>\n                      HPV DNA testing, cytology, Hybrid Capture 2, genotyping and blood samples for HIV. Visual inspection with acetic acid was performed, and sociodemographic, lifestyle and sexual\/reproductive characteristics were collected through a standardised questionnaire.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings to date<\/jats:title>\n                    <jats:p>4043 women were included in the cohort from August 2015 to May 2017. At baseline, 696 (17.1%) women were HR HPV positive, and among these, 31.6% were HIV positive; 139 women (3.4%) had high-grade squamous intraepithelial lesions. 3074 women (81%) attended the first follow-up. The majority attended after receiving a phone call reminder (35%) or from home via self-samples (41%). At first follow-up, 438 (14.4%) were HR HPV positive and 30.4% of these were HIV positive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Future plans<\/jats:title>\n                    <jats:p>A second follow-up is underway (17 December 2018\u2013October 2020). We plan to integrate our data with a previous cross-sectional HPV study from Tanzania to increase the power of our findings. Researchers interested in collaborating are welcomed, either by extracting data or jointly requesting further investigation from the cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-038531","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T18:30:14Z","timestamp":1600453814000},"page":"e038531","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Comprehensive Cervical Cancer Prevention in Tanzania (CONCEPT) study: Cohort profile"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct02509702","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Bariki","family":"Mchome","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Swai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunsen","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnson","family":"Katanga","sequence":"additional","affiliation":[{"name":"Department for Cancer Prevention Services, Ocean Road Cancer Institute, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crispin","family":"Kahesa","sequence":"additional","affiliation":[{"name":"Department for Cancer Prevention Services, Ocean Road Cancer Institute, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Manongi","sequence":"additional","affiliation":[{"name":"Department of Public Health, Kilimanjaro Chrstian Medical College, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius D","family":"Mwaiselage","sequence":"additional","affiliation":[{"name":"Department for Cancer Prevention Services, Ocean Road Cancer Institute, Dar es Salaam, United Republic of Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Kjaer","sequence":"additional","affiliation":[{"name":"Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark"},{"name":"Department of Gynaecology, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibeke","family":"Rasch","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0851-6760","authenticated-orcid":false,"given":"Ditte S\u00f8ndergaard","family":"Linde","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,18]]},"reference":[{"key":"2026062608031960000_10.9.e038531.1","unstructured":"Organization WH . Improving data for decision-making: a toolkit for cervical cancer prevention and control programmes, 2018. Available: http:\/\/apps.who.int\/iris"},{"key":"2026062608031960000_10.9.e038531.2","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.bpobgyn.2017.08.006","article-title":"Epidemiology and burden of HPV-related disease","volume":"47","author":"Serrano","year":"2018","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2026062608031960000_10.9.e038531.3","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-16-0858"},{"key":"2026062608031960000_10.9.e038531.4","unstructured":"Bruni LB-RL AG , Serrano B . Human papillomavirus and related diseases in Tanzania.Summary report. 15. ICO Information Centre on HPV and Cancer, 2016."},{"key":"2026062608031960000_10.9.e038531.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h3084"},{"key":"2026062608031960000_10.9.e038531.6","doi-asserted-by":"publisher","DOI":"10.1086\/657321"},{"key":"2026062608031960000_10.9.e038531.7","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiq172"},{"key":"2026062608031960000_10.9.e038531.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0085429","article-title":"High-Risk cervical human papillomavirus infections among human immunodeficiency virus-positive women in the Bahamas","volume":"9","author":"Dames","year":"2014","journal-title":"PLoS One"},{"key":"2026062608031960000_10.9.e038531.9","doi-asserted-by":"crossref","DOI":"10.1002\/jia2.25110","article-title":"Evidence of synergistic relationships between HIV and human papillomavirus (HPV): systematic reviews and meta-analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status","volume":"21","author":"Looker","year":"2018","journal-title":"J Int AIDS Soc"},{"key":"2026062608031960000_10.9.e038531.10","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28712"},{"key":"2026062608031960000_10.9.e038531.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0217485","article-title":"One-Way SMS and healthcare outcomes in Africa: systematic review of randomised trials with meta-analysis","volume":"14","author":"Linde","year":"2019","journal-title":"PLoS One"},{"key":"2026062608031960000_10.9.e038531.12","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-656","article-title":"Age-Specific prevalence of human papilloma virus infection among Nigerian women","volume":"14","author":"Akarolo-Anthony","year":"2014","journal-title":"BMC Public Health"},{"key":"2026062608031960000_10.9.e038531.13","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.27485"},{"key":"2026062608031960000_10.9.e038531.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015653"},{"key":"2026062608031960000_10.9.e038531.15","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.aogh.2015.08.026","article-title":"Global variation of human papillomavirus genotypes and selected genes involved in cervical malignancies","volume":"81","author":"Husain","year":"2015","journal-title":"Ann Glob Health"},{"key":"2026062608031960000_10.9.e038531.16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0122488"},{"key":"2026062608031960000_10.9.e038531.17","unstructured":"Bruni LAG , Serrano B , Mena M , et al . ICO\/IARC information centre on HPV and cancer (HPV information centre). human papillomavirus and related diseases in Tanzania. summary report 17 June, 2019."},{"key":"2026062608031960000_10.9.e038531.18","unstructured":"Organization WH . Human papillomavirus (HPV) and cervical cancer, 2019. Available: https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/human-papillomavirus-(hpv)-and-cervical-cancer."},{"key":"2026062608031960000_10.9.e038531.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-1702(02)00187-9"},{"key":"2026062608031960000_10.9.e038531.20","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0174117"},{"key":"2026062608031960000_10.9.e038531.21","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1093\/ije\/dyx050","article-title":"Cohort profile: African collaborative center for microbiome and genomics research's (ACCME's) human papillomavirus (HPV) and cervical cancer study","volume":"46","author":"Adebamowo","year":"2017","journal-title":"Int J Epidemiol"},{"key":"2026062608031960000_10.9.e038531.22","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31823b50ad"},{"key":"2026062608031960000_10.9.e038531.23","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2012-050685"},{"key":"2026062608031960000_10.9.e038531.24","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv367"},{"key":"2026062608031960000_10.9.e038531.25","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-054012"},{"key":"2026062608031960000_10.9.e038531.26","article-title":"Cytology versus HPV testing for cervical cancer screening in the general population","volume":"8","author":"Koliopoulos","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2026062608031960000_10.9.e038531.27","doi-asserted-by":"crossref","DOI":"10.1186\/s13063-017-2215-x","article-title":"Text messages to increase attendance to follow-up cervical cancer screening appointments among HPV-positive Tanzanian women (Connected2Care): study protocol for a randomised controlled trial","volume":"18","author":"Linde","year":"2017","journal-title":"Trials"},{"key":"2026062608031960000_10.9.e038531.28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024011"},{"key":"2026062608031960000_10.9.e038531.29","doi-asserted-by":"crossref","unstructured":"Linde D , Andersen MS , Mwaiselage JD , et al . One-Way text messages versus no text messages on attendance to follow-up cervical cancer screening among HPV-positive Tanzanian women (Connected2Care): a parallel-group randomised controlled trial. SSRN Journal 2019:15863. doi:10.2139\/ssrn.3405601","DOI":"10.2139\/ssrn.3405601"},{"key":"2026062608031960000_10.9.e038531.30","doi-asserted-by":"crossref","DOI":"10.1186\/s12905-020-00917-7","article-title":"\"The best thing is that you are doing it for yourself\" - perspectives on acceptability and feasibility of HPV self-sampling among cervical cancer screening clients in Tanzania: a qualitative pilot study","volume":"20","author":"Bakiewicz","year":"2020","journal-title":"BMC Womens Health"},{"key":"2026062608031960000_10.9.e038531.31","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0218559","article-title":"Performance of careHPV, hybrid capture 2 and visual inspection with acetic acid for detection of high-grade cervical lesion in Tanzania: a cross-sectional study","volume":"14","author":"Katanga","year":"2019","journal-title":"PLoS One"},{"key":"2026062608031960000_10.9.e038531.32","doi-asserted-by":"crossref","DOI":"10.2196\/15863","article-title":"Effectiveness of one-way text messaging on attendance to follow-up cervical cancer screening among human papillomavirus-positive Tanzanian women (Connected2Care): parallel-group randomized controlled trial","volume":"22","author":"Linde","year":"2020","journal-title":"J Med Internet Res"},{"key":"2026062608031960000_10.9.e038531.33","article-title":"Hpv types, cervical high-grade lesions and risk factors for oncogenic human papillomavirus infection among 3416 Tanzanian women","author":"Mchome","year":"2020","journal-title":"Sex Transm Infect"},{"key":"2026062608031960000_10.9.e038531.34","unstructured":"jhpiego . Cervical cancer prevention guidelines for low-resource settings, 2011. Available: http:\/\/resources.jhpiego.org\/system\/files\/resources\/cecap_trainer_0.pdf"},{"key":"2026062608031960000_10.9.e038531.35","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000005"},{"key":"2026062608031960000_10.9.e038531.36","unstructured":"Paul D , Blumenthal NM . Cervical cancer prevention guidelines for low-resource settings 2007: Jhpiego, 2005. Available: http:\/\/reprolineplus.org\/system\/files\/resources\/CeCaPfullmanual.pdf"},{"key":"2026062608031960000_10.9.e038531.37","doi-asserted-by":"publisher","DOI":"10.1159\/000381842"},{"key":"2026062608031960000_10.9.e038531.38","doi-asserted-by":"crossref","DOI":"10.3390\/ijms19092704","article-title":"Clinical Evaluation of INNO-LiPA HPV Genotyping EXTRA II Assay Using the VALGENT Framework","volume":"19","author":"Xu","year":"2018","journal-title":"Int J Mol Sci"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-038531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:09:29Z","timestamp":1782486569000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-038531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":38,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,18]]},"published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1136\/bmjopen-2020-038531"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-038531","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}