{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:34:12Z","timestamp":1791538452625,"version":"4.3.4"},"reference-count":18,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"6","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Global Oncology"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>Detection of high-risk human papillomavirus (HPV) in self-collected vaginal samples can significantly improve participation of hard-to-reach women; however, the implementation of such an approach in a real-life setting, especially in countries with limited resources, has certain challenges. Our study aimed to evaluate the feasibility, acceptability, and efficacy of implementing an HPV self-sampling\u2013based approach to screen a socioeconomically disadvantaged, unscreened population with support from community health workers (CHWs) for community mobilization, counseling, and navigation. Different triaging options for HPV-positive women were also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Women age 30 to 65 years from low socioeconomic periurban areas who had never been screened before were motivated by CHWs to attend local community centers and provide self-collected vaginal samples for careHPV testing. Screen-positive women were informed and navigated by CHWs to attend colposcopy clinics where cervical biopsy and same-day ablative treatment were offered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Women readily accepted to provide self-collected samples after counseling by CHWs. Screen positivity was 6.4%, and CHWs successfully navigated 65% of HPV-positive women to colposcopy. Cervical intraepithelial neoplasia (CIN) 2+ detection rate was 9.7 per 1,000 women screened. The HPV test had a positive predictive value of 15.3% to detect CIN 2+ lesions. Triage using visual inspection with acetic acid significantly improved the positive predictive value (49.5% to detect CIN 2+), but missed a significant number of CIN 2+ lesions. Colposcopy sensitivity was also suboptimal. Of 51 women with lesions, 80% underwent ablative treatment and the majority accepted same-day treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>CHW-driven self-sampling for HPV testing is feasible, well-accepted, and effective for screening unscreened hard-to-reach women. The screen-and-treat approach can ensure strong linkage between screening and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/go.20.00061","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T16:07:21Z","timestamp":1588090041000},"page":"658-666","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":24,"title":["Feasibility, Acceptability, and Efficacy of a Community Health Worker\u2013Driven Approach to Screen Hard-to-Reach Periurban Women Using Self-Sampled HPV Detection Test in India"],"prefix":"10.1200","author":[{"given":"Usha Rani","family":"Poli","sequence":"first","affiliation":[{"name":"MNJ Institute of Oncology & Regional Cancer Center, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Muwonge","sequence":"additional","affiliation":[{"name":"Screening Group, International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Triveni","family":"Bhoopal","sequence":"additional","affiliation":[{"name":"MNJ Institute of Oncology & Regional Cancer Center, Hyderabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Lucas","sequence":"additional","affiliation":[{"name":"Screening Group, International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partha","family":"Basu","sequence":"additional","affiliation":[{"name":"Screening Group, International Agency for Research on Cancer, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B3","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1007\/s13669-015-0133-z","volume":"4","author":"Basu P","year":"2015","journal-title":"Curr Obstet Gynecol 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Gynaecol"},{"key":"B20","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1258\/096914107782066158","volume":"14","author":"Muwonge R","year":"2007","journal-title":"J Med Screen"},{"key":"B21","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1177\/0969141318824627","volume":"26","author":"Selmouni F","year":"2019","journal-title":"J Med Screen"}],"container-title":["JCO Global Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/GO.20.00061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T03:31:50Z","timestamp":1653795110000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/GO.20.00061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1200\/GO.20.00061"],"URL":"https:\/\/doi.org\/10.1200\/go.20.00061","relation":{},"ISSN":["2687-8941"],"issn-type":[{"value":"2687-8941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11]]},"assertion":[{"value":"2020-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication 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