Trial reportJournal of the National Cancer Institute2014
Effect of VIA screening by primary health workers: randomized controlled study in Mumbai, India.
Trial report in Journal of the National Cancer Institute, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 113 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
113 citing papers in PubMed, 3 syntheses or guidelines pooled it, 239 citations in OpenAlex.
- Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review.PLoS medicine · 2022Pooled it
- Effectiveness of Visual Inspection with Acetic Acid (VIA) Screening on Cervical Cancer Mortality and Incidence - A Systematic Review and Meta-Analysis.Asian Pacific journal of cancer prevention : APJCP · 2022Pooled it
- Interventions targeted at women to encourage the uptake of cervical screening.The Cochrane database of systematic reviews · 2021Pooled it
- Effect of screening by clinical breast examination on breast cancer incidence and mortality after 20 years: prospective, cluster randomised controlled trial in Mumbai.BMJ (Clinical research ed.) · 2021Trial
- The Effect of Peer-Led Navigation Approach as a Form of Task Shifting in Promoting Cervical Cancer Screening Knowledge, Intention, and Practices Among Urban Women in Tanzania: A Randomized Controlled Trial.Cancer control : journal of the Moffitt Cancer CenterTrial
- Experiences with HPV self-sampling in India: advancing cervical cancer prevention and screening.BMC public health · 2026Article
- Challenging the assumption that experience- and training-related factors improve accuracy of cervical cancer screening image interpretation: Evidence from Tanzania.PLOS global public health · 2026Article
- Gaps in Knowledge and Practice of Cervical Cancer Screening among Primary Health Care Workers in Lagos State, Nigeria: A Cross-Sectional Study.F1000Research · 2026Article
- Effectiveness of Visual Inspection and Liquid-Based Cytology in Screening Asymptomatic Women for Cervical Neoplasia.Journal of pharmacy & bioallied sciences · 2025Article
- Interventions to Improve the Uptake of Cervical Cancer Screening with Visual Inspection with Acetic Acid: A Scoping Review.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Global Authorship Representation in Otolaryngology Clinical Trials.Laryngoscope investigative otolaryngology · 2025Article
- Acceptability and validity of HPV self-sampling for cervical cancer screening among women living in different ecological settings in India.International journal of cancer · 2025Article
- Addressing Global Disparities in Cervical Cancer Burden: A Narrative Review of Emerging Strategies.Current HIV/AIDS reports · 2025Review
- Task-sharing for non-communicable disease prevention and control in low- and middle-income countries in the context of health worker shortages: A systematic review.PLOS global public health · 2025Article
- Co-designing and evaluation of a context-appropriate strategy to improve access to early detection and care of oral, breast and cervical cancers in rural India: a formative phase implementation research protocol.Ecancermedicalscience · 2025Article
- A scoping review of evidence on routine cervical cancer screening in South Asia: investigating factors affecting adoption and implementation.Cancer causes & control : CCC · 2025Article
- Real-World Cervical Cancer Screening Uptake and Predictors of Visual Inspection With Acetic Acid Positivity Among Women Living With HIV in Care Programs in Western Kenya.JCO global oncology · 2024Article
- Navigating cancer care in India: Reflections & imperatives.The Indian journal of medical research · 2024Article
- Preparing patient navigators and assessing the impact of patient navigation in promoting cervical cancer screening uptake, knowledge, awareness, intention, and health beliefs: a protocol for a randomized controlled trial.Frontiers in global women's health · 2024Article
- Community cancer screening at primary care level in Northern India: determinants and policy implications for cancer prevention.Family medicine and community health · 2023Article
53 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundCervical cancer is the leading cause of cancer mortality among women in India. Because Pap smear screening is not feasible in India, we need to develop effective alternatives.
methodsA cluster-randomized controlled study was initiated in 1998 in Mumbai, India, to investigate the efficacy of visual inspection with acetic acid (VIA) performed by primary health workers in reducing cervical cancer mortality. Four rounds of cancer education and VIA screening were conducted at 24-month intervals in the screening group, whereas cancer education was offered once at entry to the control group. The study was planned for 16 years to include four screening rounds followed by four monitoring rounds. We present results after 12 years of follow-up. Poisson regression method was used to calculate the rate ratios (RRs); two-sided χ(2) was used to calculate the probability.
resultsWe recruited 75360 women from 10 clusters in the screening group and 76178 women from 10 comparable clusters in the control group. In the screening group, we achieved 89% participation for screening and 79.4% compliance for diagnosis confirmation. The incidence of invasive cervical cancer was 26.74 per 100000 (95% confidence interval [CI] = 23.41 to 30.74) in the screening group and 27.49 per 100000 (95% CI = 23.66 to 32.09) in the control group. Compliance to treatment for invasive cancer was 86.3% in the screening group and 72.3% in the control group. The screening group showed a statistically significant 31% reduction in cervical cancer mortality (RR = 0.69; 95% CI = 0.54 to 0.88; P = .003).
conclusionsVIA screening by primary health workers statistically significantly reduced cervical cancer mortality. Our study demonstrates the efficacy of an easily implementable strategy that could prevent 22000 cervical cancer deaths in India and 72600 deaths in resource-poor countries annually.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.