{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:46:52Z","timestamp":1777484812412,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2026,1,27]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      The World Health Organization recommends 4 triage strategies for women with high-risk human papillomavirus infection (hrHPV). These include visual inspection with acetic acid (VIA), colposcopy, reflex cytology, and HPV16\/18 partial genotyping. However, in many low-resource settings, access to colposcopy remains limited. This study aimed to compare the diagnostic accuracy of visual inspection vs colposcopy for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2\n                      <jats:sup>+<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Women who tested positive for hrHPV and were referred for colposcopy, with cytology results available as part of routine clinical care, underwent visual inspection with 3% acetic acid immediately before colposcopy. Colposcopic impressions were recorded, and images were scored using a modified Reid colposcopic index and a modified Swede score without iodine staining. We compared diagnostic performance for CIN2\n                      <jats:sup>+<\/jats:sup>\n                      across visual inspection, colposcopic impression, modified Reid index (score \u22654), and modified Swede score (score \u22655). Statistical analysis used IBM SPSS Statistics and the Cochran Q test, with significance set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 450 women, the median age was 38.0\u00a0years. A single hrHPV type was detected in 70.4% of cases; types 16, 52, and 18 were most common. Histopathological confirmation of CIN2\n                      <jats:sup>+<\/jats:sup>\n                      occurred in 97 women (21.6%). Diagnostic accuracy for predicting CIN2\n                      <jats:sup>+<\/jats:sup>\n                      was 78.2% with VIA and 77.5% with colposcopic impression. Accuracy was 78.4% for the modified Reid index \u22654 and 78.2% for the modified Swede score \u22655. No significant differences were observed among the 4 methods (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .941).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VIA demonstrates diagnostic accuracy comparable to colposcopy-based assessments in hrHPV-positive women evaluated within a cytology-informed clinical pathway, supporting its potential role in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748261422014","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T17:40:05Z","timestamp":1769622005000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Performance of Visual Inspection with Acetic Acid and Colposcopy for Detection of Cervical Precancer in Women with High-Risk Human Papillomavirus Infection: A Cross-Sectional Study"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1892-0839","authenticated-orcid":false,"given":"Sompop","family":"Kuljarusnont","sequence":"first","affiliation":[{"name":"Mahidol University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8427-8266","authenticated-orcid":false,"given":"Wathirada","family":"Karnchanabanyong","sequence":"additional","affiliation":[{"name":"Mahidol University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9888-7479","authenticated-orcid":false,"given":"Irene","family":"Ruengkhachorn","sequence":"additional","affiliation":[{"name":"Mahidol University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4313-823X","authenticated-orcid":false,"given":"Methawee","family":"Ularnwong","sequence":"additional","affiliation":[{"name":"Mahidol University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4517-2407","authenticated-orcid":false,"given":"Pornprom","family":"Ittiamornlert","sequence":"additional","affiliation":[{"name":"Mahidol University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4392-0811","authenticated-orcid":false,"given":"Suchanan","family":"Hanamornroongruang","sequence":"additional","affiliation":[{"name":"Mahidol University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_3_9_2_2","unstructured":"WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of mRNA tests for human papillomavirus (HPV) 2021 [Internet]. Available from:. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/35044737. Access on June 14 2025."},{"key":"e_1_3_9_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000525"},{"key":"e_1_3_9_4_2","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30060425"},{"key":"e_1_3_9_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-020-0920-9"},{"key":"e_1_3_9_6_2","unstructured":"ICO\/IARC HPV Information Centre. Thailand human papillomavirus and related cancers fact sheet 2023 [Internet]. Available from:. https:\/\/hpvcentre.net\/statistics\/reports\/THA_FS.pdf. Access on June 14 2025."},{"key":"e_1_3_9_7_2","doi-asserted-by":"publisher","DOI":"10.31557\/APJCP.2021.22.1.25"},{"key":"e_1_3_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2025.04.048"},{"key":"e_1_3_9_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000593"},{"key":"e_1_3_9_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e31826b683e"},{"key":"e_1_3_9_11_2","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.23089"},{"key":"e_1_3_9_12_2","volume-title":"A Practical Manual on Visual Screening for Cervical Neoplasia","author":"Sankaranarayanan R","year":"2003","unstructured":"Sankaranarayanan R, Wesley R. A Practical Manual on Visual Screening for Cervical Neoplasia. Lyon: IARCPress. 2003 [Internet]. Available from. https:\/\/publications.iarc.fr\/Book-And-Report-Series\/Iarc-Technical-Publications\/A-Practical-Manual-On-Visual-Screening-For-Cervical-Neoplasia-2003. 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