ArticleHIV therapy2010
Implementation of cervical cancer prevention services for HIV-infected women in Zambia: measuring program effectiveness.
Article in HIV therapy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Uptake and barriers to cervical cancer screening among human immunodeficiency virus-positive women in Sub Saharan Africa: a systematic review and meta-analysis.BMC women's health · 2023Pooled it
- Pooled it
- A portable thermal ablation device for cervical cancer prevention in a screen-and-treat setting: a randomized, noninferiority trial.Nature medicine · 2024Trial
- Primary Tumors of the Brain and Central Nervous System in Adults and Children in Sub-Saharan Africa: Protocol for a Scoping Review.JMIR research protocols · 2025Article
- Prevention of Cervical Cancer in Low-Resource African Settings.Obstetrics and gynecology clinics of North America · 2022Review
- Cervical cancer diagnosis and treatment delays in the developing world: Evidence from a hospital-based study in Zambia.Gynecologic oncology reports · 2021Article
- Association between cervical dysplasia and female genital schistosomiasis diagnosed by genital PCR in Zambian women.BMC infectious diseases · 2021Article
- Women's experiences in a community-based screen-and-treat cervical cancer prevention program in rural Malawi: a qualitative study.BMC cancer · 2021Article
- Gynecologic Oncology Sub-Specialty Training in Ghana: A Model for Sustainable Impact on Gynecologic Cancer Care in Sub-Saharan Africa.Frontiers in public health · 2020Review
- Integrated Care Delivery for HIV Prevention and Treatment in Adolescent Girls and Young Women in Zambia: Protocol for a Cluster-Randomized Controlled Trial.JMIR research protocols · 2019Article
- From potential to practice: how accelerating access to HPV tests and screen and treat programmes can help eliminate cervical cancer.Family medicine and community health · 2019Review
- A tailored approach to building specialized surgical oncology capacity: Early experiences and outcomes in Malawi.Gynecologic oncology reports · 2018Review
- Cost-Effectiveness of Cervical Cancer Screening in Women Living With HIV in South Africa: A Mathematical Modeling Study.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Early experiences in integrating cervical cancer screening and treatment into HIV services in Zomba Central Hospital, Malawi.Malawi medical journal : the journal of Medical Association of Malawi · 2018Article
- Impact of HIV on human papilloma virus-mediated cervical disease progression.AIDS (London, England) · 2018Article
- Acceptance of Cervical Cancer Screening and its Correlates Among Women of a Peri-Urban High-Density Residential Area in Ndola, Zambia.International journal of MCH and AIDS · 2018Article
- Evaluation of research on interventions aligned to WHO 'Best Buys' for NCDs in low-income and lower-middle-income countries: a systematic review from 1990 to 2015.BMJ global health · 2018Article
- Clinical Performance Validation of 4 Point-of-Care Cervical Cancer Screening Tests in HIV-Infected Women in Zambia.Journal of lower genital tract disease · 2016Article
- Characteristics of Blood Vessels in Female Genital Schistosomiasis: Paving the Way for Objective Diagnostics at the Point of Care.PLoS neglected tropical diseases · 2016Article
- Implementation and Operational Research: Age Distribution and Determinants of Invasive Cervical Cancer in a "Screen-and-Treat" Program Integrated With HIV/AIDS Care in Zambia.Journal of acquired immune deficiency syndromes (1999) · 2015Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
backgroundCervical cancer kills more women in low-income nations than any other malignancy. A variety of research and demonstration efforts have proven the efficacy and effectiveness of low-cost cervical cancer prevention methods but none in routine program implementation settings of the developing world, particularly in HIV-infected women.
methodsIn our public sector cervical cancer prevention program in Zambia, nurses conduct screening using visual inspection with acetic acid aided by digital cervicography. Women with visible lesions are offered same-visit cryotherapy or referred for histologic evaluation and clinical management. We analyzed clinical outcomes and modeled program effectiveness among HIV-infected women by estimating the total number of cervical cancer deaths prevented through screening and treatment.
resultsBetween 2006 and 2008, 6572 HIV-infected women were screened, 53.6% (3523) had visible lesions, 58.5% (2062) were eligible for cryotherapy and 41.5% (1461) were referred for histologic evaluation. A total of 75% (1095 out of 1462) of patients who were referred for evaluation complied. Pathology results from 65% (715 out of 1095) of women revealed benign abnormalities in 21% (151), cervical intraepithelial neoplasia (CIN) I in 30% (214), CIN 2/3 in 33% (235) and invasive cervical cancer in 16.1% (115, of which 69% were early stage). Using a conditional probability model, we estimated that our program prevented 142 cervical cancer deaths (high/low range: 238-96) among the 6572 HIV-infected women screened, or one cervical cancer death prevented per 46 (corresponding range: 28-68) HIV-infected women screened.
conclusionOur prevention efforts using setting-appropriate human resources and technology have reduced morbidity and mortality from cervical cancer among HIV-infected women in Zambia. Financial support for implementing cervical cancer prevention programs integrated within HIV/AIDS care programs is warranted. Our prevention model can serve as the implementation platform for future low-cost HPV-based screening methods, and our results may provide the basis for comparison of programmatic effectiveness of future prevention efforts.
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