{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T04:26:14Z","timestamp":1794543974850,"version":"4.9.1"},"reference-count":30,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2022,4,3]],"date-time":"2022-04-03T00:00:00Z","timestamp":1648944000000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Comit\u00e9 des affaires humanitaires, Geneva University Hospitals"},{"name":"ESTHER Switzerland","award":["17G1"],"award-info":[{"award-number":["17G1"]}]},{"name":"Solidarit\u00e9 Internationale Gen\u00e8ve"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,3,16]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>A simple system for visual inspection with acetic acid assessment, named ABCD criteria, has been developed to increase accuracy for triaging of high-risk human papillomavirus (HPV)-positive women. This study aimed to determine the accuracy of ABCD criteria for the detection of histologically confirmed cervical intraepithelial neoplasia grade two or worse (CIN2+) in HPV-positive women living in a low-resource setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective study of diagnostic accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Cervical cancer screening programme based on a 3T-Approach (test, triage and treat) in the Health District of Dschang, West Cameroon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Asymptomatic non-pregnant women aged 30\u201349 years were eligible to participate. Exclusion criteria included history of CIN treatment, anogenital cancer or hysterectomy. A total of 1980\u2009women were recruited (median age, 40 years; IQR 35\u201345 years), of whom 361 (18.4%) were HPV-positive and 340 (94.2%) completed the trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>HPV-positive women underwent a pelvic examination for visual assessment of the cervix according to ABCD criteria. The criteria comprised A for acetowhiteness, B for bleeding, C for colouring and D for diameter. The ABCD criteria results were codified as positive or negative and compared with histological analysis findings (reference standards).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Diagnostic performance of ABCD criteria for CIN2+, defined as sensitivity, specificity, negative and positive predictive values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ABCD criteria had a sensitivity of 77.5% (95% CI 61.3% to 88.2%), specificity of 42.0% (95% CI 36.5% to 47.7%), positive predictive value of 15.1% (95% CI 10.8% to 20.8%), and negative predictive value of 93.3% (95% CI 87.6% to 96.5%) for detection of CIN2 +lesions. Most (86.7%) of the ABCD-positive women were treated on the same day.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ABCD criteria can be used in the context of a single-visit approach and may be the preferred triage method for management of HPV-positive women in a low-income context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03757299\">NCT03757299<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-052504","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T12:14:30Z","timestamp":1649074470000},"page":"e052504","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["ABCD criteria to improve visual inspection with acetic acid (VIA) triage in HPV-positive women: a prospective study of diagnostic accuracy"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct03757299","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Patrick","family":"Petignat","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Kenfack","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine and Pharmaceutical Science, University of Dschang, Dschang, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3942-2134","authenticated-orcid":false,"given":"Ania","family":"Wisniak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Essia","family":"Saiji","sequence":"additional","affiliation":[{"name":"Division of Clinical Pathology, Diagnostic Department, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Tille","sequence":"additional","affiliation":[{"name":"Division of Clinical Pathology, Diagnostic Department, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jovanny","family":"Tsuala Fouogue","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Mbouda District Hospital, Mbouda, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Catarino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eveline","family":"Tincho","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Faculty of Medicine and Pharmaceutical Science, University of Dschang, Dschang, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Vassilakos","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland"},{"name":"Geneva Foundation for Medical Education and Research, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"2025121410314052000_12.4.e052504.1","unstructured":"GLOBOCAN 2020. 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