{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:59:10Z","timestamp":1792202350583,"version":"4.4.0"},"reference-count":38,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"7","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Global Oncology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Adjunct cervical cancer screening methods are under evaluation to improve the diagnostic accuracy of human papillomavirus (HPV)-based screening in low- and middle-income countries. We evaluated the feasibility and acceptability of smartphone-based cervicography among HPV-positive women living with HIV (WLWH) in Western Kenya. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> HPV-positive WLWH of 25-49 years of age enrolled in a clinical trial (ClinicalTrials.gov identifier: NCT04191967 ) had digital images of the cervix taken using a smartphone by a nonphysician provider following visual inspection with acetic acid. All participants had colposcopy-directed biopsy before treatment. Cervical images were evaluated by three off-site colposcopists for quality, diagnostic utility, and assigned a presumed diagnosis. We determined the proportion of images rates as low, medium, or high quality, interobserver agreement using Cohen\u2019s Kappa statistic, and the off-site colposcopist\u2019s sensitivity and specificity for diagnosis of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) compared with histopathology. Acceptability was evaluated using a questionnaire. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> One hundred sixty-four HPV-positive WLWH underwent cervicography during the study period. Mean age was 37.3 years. Images from the first 94 participants were evaluated by off-site colposcopists, with a majority (70.9%) rated as high quality. Off-site colposcopists had a sensitivity ranging from 21.4% (95% CI, 0.06 to 0.43) to 35.7% (95% CI, 0.26 to 0.46) and a specificity between 85.5% (95% CI, 0.81 to 0.90) to 94.9% (95% CI, 0.92 to 0.98) for diagnosis of CIN2+ based compared with histopathology. The majority of women, 99.4%, were comfortable having an image of their cervix taken as part of screening. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> Cervicography by a nonphysician provider as an adjunct to HPV-based screening among WLWH in a low- and middle-income country setting is feasible and acceptable. However, low sensitivity for diagnosis of CIN2+ by off-site expert colposcopists highlights the limitations of cervicography. <\/jats:p><\/jats:sec>","DOI":"10.1200\/go.21.00013","type":"journal-article","created":{"date-parts":[[2021,5,17]],"date-time":"2021-05-17T19:59:33Z","timestamp":1621281573000},"page":"686-693","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":17,"title":["Feasibility and Acceptability of Smartphone-Based Cervical Cancer Screening Among HIV-Positive Women in Western Kenya"],"prefix":"10.1200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-4721","authenticated-orcid":false,"given":"Chemtai","family":"Mungo","sequence":"first","affiliation":[{"name":"Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cirilus 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Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Rush University School of Medicine, Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anagha","family":"Guliam","sequence":"additional","affiliation":[{"name":"Barnard College, University of Columbia, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackton","family":"Omoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maseno University School of Medicine, Kisumu, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, 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