ArticleInternational journal of cancer2023
Performance of visual inspection of the cervix with acetic acid (VIA) for triage of HPV screen-positive women: results from the ESTAMPA study.
Article in International journal of cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Visual Inspection with Acetic Acid Positivity in Screening and Early Detection of Cervical Dysplasia in Africa, 2023: A Meta-Analysis.Ethiopian journal of health sciences · 2024Pooled it
- Cervical Cancer Screening and Treatment Algorithms Using Human Papillomavirus Testing-Lessons Learnt from a South African Pilot Randomized Controlled Trial.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Trial
- Triage of HPV positivity in a high HIV prevalence setting: A prospective cohort study comparing visual triage methods and HPV genotype restriction in Botswana.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2024Trial
- Resource-Adapted Triage Strategies for Women Testing HPV Positive With Self-Collected Vaginal Samples in Cameroon.International journal of cancer · 2026Article
- Real-World Performance of HPV DNA-Based Screening in Health Resource-Limited Areas of China: A Multicenter Implementation Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Diagnostic Utility of Acetic Acid-induced Acetowhite Change in Suspected Penile Intraepithelial Neoplasia.Cureus · 2026Article
- Applying FRAME-IS to characterize provider-led adaptations to a cervical cancer prevention intervention in Kenya.Implementation science communications · 2026Article
- Article
- Screen-and-treat: a sustainable solution for cervical cancer elimination in low and middle income countries.BMJ oncology · 2026Review
- Cervical Cancer Screening in Transition: Global Challenges and Local Realities.International journal of women's health · 2026Review
- Concordance of AI-Assisted and Hybrid AI-Assisted Cervical Imaging Systems with Visual Inspection with Acetic Acid for Cervical Precancer Screening in West Bandung, Indonesia.International journal of women's health · 2026Article
- Short-term repeat HPV testing for triaging HPV-positive women in cervical cancer screening.British journal of cancer · 2025Observational
- Review
- To determine the diagnostic accuracy of visual inspection of cervix with acetic acid as a screening tool to detect preinvasive cervical cancer - A meta-analysis.Journal of family medicine and primary care · 2025Review
- Review
- A randomised controlled non-inferiority trial to compare the efficacy of 'HPV screen, triage and treat' with 'HPV screen and treat' approach for cervical cancer prevention among women living with HIV.Nature communications · 2025Article
- Performance of visual inspection, partial genotyping, and their combination for the triage of women living with HIV who are screen positive for human papillomavirus: Results from the AIMA-CC ANRS 12375 multicentric screening study.International journal of cancer · 2025Article
- A pilot study of upcycled smartphone-based colposcopy for visual inspection of cervix performed by community healthcare workers in rural Vietnam.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Article
- Integrated HPV Testing, TCT, and Colposcopic VIA/VILI Improves Detection Rate for HSIL and Cervical Cancer: A Retrospective Cohort in China.International journal of women's health · 2025Article
- Do Human Papilloma Virus and Cytological Testing Results Before Colposcopy Alter the Pathological Grading of Colposcopy Acetic Acid Visual Examination?: A Retrospective Study.International journal of women's health · 2025Article
Corrections and comments
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Authors and funding
31 authors at 14 institutions in 11 countries.
Funding
Abstract
VIA is recommended for triage of HPV-positive women attending cervical screening. In the multicentric ESTAMPA study, VIA performance for detection of cervical intraepithelial neoplasia grade 3 or worse (CIN3+) among HPV-positive women was evaluated. Women aged 30-64 years were screened with HPV testing and cytology and referred to colposcopy if either test was positive. At colposcopy visit, study-trained midwives/nurses/GPs performed VIA ahead of colposcopy. VIA was considered positive if acetowhite lesions were observed in or close to the transformation zone. Ablative treatment eligibility was assessed for VIA positives. Performance indicators were estimated. Three thousand one hundred and forty-two HPV-positive women were included. Sensitivity for CIN3+ was 85.9% (95% CI 81.2-89.5) among women <50 years and, although not significant, slightly lower in women 50+ (78.0%, 95% CI 65.9-86.6). Overall specificity was 58.6% (95% CI 56.7-60.5) and was significantly higher among women 50+ (70.3%, 95% CI 66.8-73.5) compared to women <50 (54.3%, 95% CI 52.1-56.5). VIA positivity was lower among women 50+ (35.2%, 95% CI 31.9-38.6) compared to women <50 (53.2, 95% CI 51.1-55.2). Overall eligibility for ablative treatment was 74.5% and did not differ by age. VIA sensitivity, specificity, and positivity, and ablative treatment eligibility varied highly by provider (ranges: 25%-95.4%, 44.9%-94.4%, 8.2%-65.3%, 0%-98.7%, respectively). VIA sensitivity for cervical precancer detection among HPV-positive women performed by trained providers was high with an important reduction in referral rates. However, scaling-up HPV screening triaged by VIA will be challenging due to the high variability of VIA performance and providers' need for training and supervision.
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