ArticleBMJ open2017
Cervical cancer screening in rural Bhutan with the
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Barriers to cancer screening uptake and approaches to overcome them: a systematic literature review.Frontiers in oncology · 2025Pooled it
- Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses.BMJ (Clinical research ed.) · 2018Pooled it
- Prevalence of CMV, EBV, HPV, and HSV among South Asian healthy population: A systematic review and meta-analysis.PLOS global public health · 2026Article
- Scaling HPV Self-Sampling in Low-Resource Settings: From Evidence to Sustainable Implementation.International journal of women's health · 2026Review
- High-risk human papillomavirus genotypes among women of hill districts in Bangladesh.PloS one · 2025Article
- Performance of HPV Self-Sample Collected by a Novel Kit in Comparison with Clinician Collected Sample for Cervical Cancer Screening.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Population-level cancer screening and cancer care in Bhutan, 2020-2023: a review.The Lancet regional health. Southeast Asia · 2024Review
- Cancer burden across the South Asian Association for Regional Cooperation in 2022.BMJ oncology · 2024Article
- Improving care seeking behavior toward cervical cancer screening participation among Gwafan community women, North-Central Nigeria.BMC women's health · 2023Article
- Human papillomavirus testing on self-collected samples to detect high-grade cervical lesions in rural Bhutan: The REACH-Bhutan study.Cancer medicine · 2023Article
- Self-Collection Cervical Screening in the Asia-Pacific Region: A Scoping Review of Implementation Evidence.JCO global oncology · 2023Article
- Cross-sectional survey of the impact of the COVID-19 pandemic on cancer screening programs in selected low- and middle-income countries: Study from the IARC COVID-19 impact study group.International journal of cancer · 2021Article
- Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia.Cancers · 2021Review
- Human Papilloma Virus self-sampling performance in low- and middle-income countries.BMC women's health · 2021Review
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- Review
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- Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda.BMC women's health · 2018Article
- Evaluation of cytology versus human papillomavirus-based cervical cancer screening algorithms in Bhutan.Oncotarget · 2017Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesThe Bhutanese Screening Programme recommends a Pap smear every 3 years for women aged 25-65 years, and coverage ranges from 20% to 60%, being especially challenging in rural settings. The 'REACH-Bhutan' study was conducted to assess the feasibility and outcomes of a novel approach to cervical cancer screening in rural Bhutan.
designCross-sectional, population-based study of cervical cancer screening based on the
settingWomen were recruited in rural primary healthcare centres, that is, Basic Health Units (BHU), across Bhutan.
participantsOverall, 3648 women aged 30-60 were invited from 15 BHUs differing in accessibility, size and ethnic composition of the population.
interventionsParticipants provided a self-collected cervicovaginal sample and were interviewed. Samples were tested using
main outcome measuresScreening participation by geographic area, centre, age and travelling time. Previous screening history and
resultsIn April/May 2016, 2590 women (median age: 41) were enrolled. Study participation was 71% and significantly heterogeneous by BHU (range: 31%-96%). Participation decreased with increase in age (81% in women aged 30-39 years; 59% in ≥50 years) and travelling time (90% in women living <30 min from the BHU vs 62% among those >6 hours away). 50% of participants reported no previous screening, with the proportion of never-screened women varying significantly by BHU (range: 2%-72%). 265 women (10%; 95% CI 9% to 11%) were
conclusionsCommunity-based cervical cancer screening by testing self-collected samples for human papillomavirus (HPV) can achieve high coverage in rural Bhutan. However, solutions to bring self-collection, HPV testing and precancer treatment closer to the remotest villages are needed.
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