ArticleBMJ open2019
Prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian Women: a comparison of human papilloma virus testing, visualization with acetic acid and digital colposcopy.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Facilitators and barriers to cervical cancer screening among women living with HIV: a systematic review of qualitative studies.Frontiers in public health · 2026Pooled it
- Human papillomavirus self-sampling in Asia: a systematic review.Frontiers in microbiology · 2025Pooled it
- A new model for cervical cancer screening in Cambodian garment workers.BMJ global health · 2026Article
- The Callascope: A portable, user-friendly, speculum-free device for diagnostic imaging of cervical cancer precursor lesions.npj women's health · 2026Article
- Evolution of Pathological Techniques for the Screening of Cervical Cancer: A Comprehensive Review.Cureus · 2024Review
- Feasibility, accuracy and acceptability of self-sampled human papillomavirus testing using careHPV in Cambodia: a cross-sectional study.Journal of gynecologic oncology · 2024Article
- Automated Assessment of Digital Images of Uterine Cervix Captured Using Transvaginal Device-A Pilot Study.Diagnostics (Basel, Switzerland) · 2023Article
- Comment on Self-Sampling Methodology Impression for Cervical Cancer Screening.Asian Pacific journal of cancer prevention : APJCP · 2023Article
- Digital cervicography for cervical cancer screening in low-resource settings: A scoping review.Gynecologic oncology reports · 2023Article
- Self-Collection Cervical Screening in the Asia-Pacific Region: A Scoping Review of Implementation Evidence.JCO global oncology · 2023Article
- Mobile colposcopy by trained nurses in a cervical cancer screening programme at Battor, Ghana.Ghana medical journal · 2022Article
- Smartphone-Based Visual Inspection with Acetic Acid: An Innovative Tool to Improve Cervical Cancer Screening in Low-Resource Setting.Healthcare (Basel, Switzerland) · 2022Review
- Analysis of Distributions of HPV Infection in Females with Cervical Lesions in the Western District of Beijing Chaoyang Hospital.Journal of healthcare engineering · 2022Article
- Cervical cancer prevention and control in women living with human immunodeficiency virus.CA: a cancer journal for clinicians · 2021Review
- A pilot study of mobile digital colposcopy in Japanese patients with cervical intraepithelial neoplasm.Molecular and clinical oncology · 2021Article
- Comparative Study of Smart Scope® Visual Screening Test with Naked Eye Visual Screening and Pap Test.Asian Pacific journal of cancer prevention : APJCP · 2020Observational
- Article
- The use of molecular markers for cervical screening of women living with HIV in South Africa.AIDS (London, England) · 2019Article
- Advances in technologies for cervical cancer detection in low-resource settings.Expert review of molecular diagnostics · 2019Review
- Diagnostic Efficacy of Enhanced Visual Assessment [Visual Check] for Triaging Cervical Cancer Screen Positive Women.Journal of mid-life healthArticle
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesLogistical and economic issues make traditional cytology-based cervical cancer screening challenging in developing countries. Alternative, cost-effective, screening strategies must be developed to screen millions of women in resource-poor countries such as Cambodia.
designA prospective cohort study during which all women underwent four cervical cancer screening methods: (1) self-sampled human papilloma virus (HPV) testing (careHPV system), (2) clinician-collected HPV testing, (3) visualization with acetic acid (VIA) and (4) digital colposcopy (DC) with the Enhanced Visual Assessment System (EVA).
settingA referral hospital in Phnom Penh, Cambodia.
participantsTwo hundred and fifty Cambodian women (129 HIV+, 121 HIV-). Subjects were recruited from the National Center for HIV/AIDS Dermatology and sexually transmitted disease (STD) cohort, the Sihanouk Hospital Center of Hope's Rural Outreach Teams and the Pochentong Medical Center.
resultsFifty six of the 250 (22.4%) patients tested positive for high-risk HPV (hrHPV+). Thirty seven of the 129 HIV+ women were hrHPV+ (28.6%) whereas 19/121 HIV- women were hrHPV+ (15.7%) p=0.0154. Self-sampling HPV specimens identified 50/56 (89%) whereas physician-collected specimens identified 45/56 (80%) p=0.174. 95.2% of the patients felt comfortable obtaining HPV self-samples. Thirty seven of 250 women were VIA+. Thirty of 37 VIA+ women underwent confirmatory biopsies for cervical intraepithelial neoplasia (CIN) (26 CIN1, 4 CIN2+). The rate of confirmed dysplasia in the HIV+ group was 20/129 (15.5%) compared with 10/121 (8.26%) in HIV- women p=0.0291. The contemporaneous physician impressions of the DC images accurately differentiated between CIN1 and CIN2+ lesions in all 30 women having confirmatory biopsies.
conclusionsThe results of this study suggest potential modifications of the current cervical screening strategy that is currently being employed in Cambodia. The first step in this new strategy would be self-swabbing for hrHPV. Subsequently, hrHPV+ patients would have DC and immediate treatment based on colposcopic findings: cryotherapy for suspected CIN1 and loop electrosurgical excision procedure (LEEP) for suspected CIN2+.
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