ArticleLancet regional health. Americas2023
Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: an analysis within the ESTAMPA study.
Article in Lancet regional health. Americas, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
What it found
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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
50 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Liquid Biopsy Biomarkers for Cervical Cancer: A Systematic Review.International journal of molecular sciences · 2025Pooled it
- Patient acceptance of HPV self-sampling approach for cervical cancer screening: evidence from a pilot study in Kazakhstan.Annals of medicine · 2026Article
- Triage Performance of FAM19A4/miR124-2 Methylation: 18-Month Follow-Up Results From a Prospective Observational Study Within the Dutch Primary HPV-Based Cervical Screening Program.International journal of cancer · 2026Observational
- Nationwide Study on the Cervical Cancer Screening Pathway in Estonia.International journal of cancer · 2026Article
- Primary Human Papillomavirus Screening Versus Cytology for Detection of Cervical Intraepithelial Neoplasia Grade 2 or Higher in Poland: a Parallel-Group, Randomized Controlled Trial.The Lancet regional health. Europe · 2026Article
- Urban-rural disparities in HPV prevalence and genotype distribution: a large-scale cervical cancer screening study in Xi'an, China.BMC infectious diseases · 2026Article
- Risk-Based Triage Using Cytology and HPV Genotyping to Reduce Unnecessary Colposcopy: A Real-World Cross-Sectional Study.Biomedicines · 2026Article
- Prevalence and persistence of high-risk HPV genotypes in unvaccinated asymptomatic women: a six-year study in Peru.BMC research notes · 2026Article
- Cost-effectiveness of Including p16/Ki-67 Dual Staining in the Detection of Cervical Lesions in Colombia, 2024Revista colombiana de obstetricia y ginecologia · 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
- Trends in over- and under-screening for cervical cancer after EMR implementation in rural China.NPJ digital medicine · 2026Article
- Cervical Cytology and HPV16/18/45 mRNA Co-Testing Improve Risk Stratification in Routine Clinical Practice.Cancers · 2026Article
- Accelerating the elimination of cervical cancer: cross-sectional examination of cancer prevention and control in Latin America and the Caribbean.Lancet regional health. Americas · 2026Article
- Testing menstrual blood for human papillomavirus during cervical cancer screening in China: cross sectional population based study.BMJ (Clinical research ed.) · 2026Observational
- Cervical Cancer Screening in Transition: Global Challenges and Local Realities.International journal of women's health · 2026Review
- Non-invasive host transcriptome and HPV oncogene expression map the molecular landscape of HPV-driven cervical lesions.PloS one · 2026Article
- Article
- The cost-saving impact of human papillomavirus self-sampling for cervical cancer screening in women workers at the manufacturing sector in Ciudad Juárez, Chihuahua, Mexico.PLOS global public health · 2026Article
- Knowledge, attitudes, and practices regarding HPV infection, cervical cancer, and HPV vaccination among Emirati women.Future oncology (London, England) · 2025Article
- Artificial Intelligence Tools for Supporting Histopathologic and Molecular Characterization of Gynecological Cancers: A Review.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
38 authors at 20 institutions in 13 countries.
Funding
Abstract
Background: Cervical cytology remains widely used as the initial tool in cervical cancer screening worldwide. WHO guidelines recommend replacing cytology with primary HPV testing to reach cervical cancer elimination goals. We assessed the performance of cytology and high-risk HPV testing to detect cervical precancer, cervical intraepithelial neoplasia (CIN) grade 3 or worse (CIN3+) among women aged 30-64 years participating in the ESTAMPA study. Methods: Women were screened with cytology and HPV across ESTAMPA study centres in Latin America. Screen-positives were referred to colposcopy with biopsy collection and treatment as needed. Those with no evident precancer were recalled at 18-months for a second HPV test to complete disease ascertainment. Performance indicators for cytology and HPV to detect CIN3+ were estimated. Findings: 30,606 participants with available cytology and HPV results were included in the analysis. A total of 440 histologically confirmed CIN3s and 30 cancers were diagnosed. Cytology sensitivity for CIN3+ was 48.5% (95% CI: 44.0-53.0), whereas HPV testing had a sensitivity of 98.1% (95% CI: 96.3-96.7). Specificity was 96.5% (95% CI: 96.3-96.7) using cytology and 88.7% (95% CI: 88.3-89.0) with HPV. Performance estimates varied substantially by study centre for cytology (ranging from 32.1% to 87.5% for sensitivity and from 89.2% to 99.5% for specificity) while for HPV results were more consistent across sites (96.7%-100% and 83.6-90.8%, respectively). Interpretation: The limited and highly variable sensitivity of cytology strongly supports transition to the more robust and reproducible HPV-based cervical screening to ensure progress towards global cervical cancer elimination targets in Latin America. Funding: IARC/WHO, UNDP, HRP/WHO, NCI and local funders.
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Registered trials
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