Evidence map›Paper›PMID 37955560›Full record

Trial reportCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2024

Cervical Cancer Screening and Treatment Algorithms Using Human Papillomavirus Testing-Lessons Learnt from a South African Pilot Randomized Controlled Trial.

Hannah M Sebitloane, Mathilde Forestier, Themba G Ginindza, Wendy Dhlomo, Eshia Moodley-Govender, Teresa M Darragh, Armando Baena, Rolando Herrero, Maribel Almonte, Nathalie Broutet and 1 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 5 countries.

Hannah M Sebitloane *Discipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.ORCID 0000-0003-4046-0653
Mathilde Forestier *Early Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France.ORCID 0000-0001-9902-5758
Themba G GinindzaPublic Health Medicine, University of KwaZulu-Natal, Durban, South Africa.ORCID 0000-0002-0993-8308
Wendy DhlomoDiscipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.ORCID 0009-0007-3483-3405
Eshia Moodley-GovenderDiscipline of Obstetrics and Gynaecology, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.ORCID 0009-0005-1626-4830
Teresa M DarraghDepartment of Pathology, University of California, San Francisco, California.ORCID 0000-0002-4382-9949
Armando BaenaEarly Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France.ORCID 0000-0001-8717-6911
Rolando HerreroEarly Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France.ORCID 0000-0001-5448-3456
Maribel AlmonteEarly Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France.ORCID 0000-0003-1623-8323
Nathalie BroutetDepartment of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.ORCID 0000-0002-3665-4861
Hugo De VuystEarly Detection, Prevention and Infections (EPR), International Agency for Research on Cancer, Lyon, France.ORCID 0000-0002-5350-4072
World Health Organization · CHUniversity of KwaZulu-Natal · ZAAfrica Health Research Institute · ZACentre international de recherche sur le cancer · FRInstituto Costarricense de Investigación y Enseñanza en Nutrición y Salud · CRUniversity of California, San Francisco · US

Funding

HRP Alliance for Research Capacity Strengthening (RCS)World Health Organization 001
6 · The paper itself

Abstract

backgroundTo report quantitative and qualitative results on cervical cancer human papillomavirus (HPV)-based screening and treatment algorithms, with/out triage with visual inspection after acetic acid (VIA), followed by ablative treatment (AT).

methodsWomen 30 to 54 years old from Durban, South Africa were recruited, regardless of human immunodeficiency virus (HIV) status, randomized into one of two study arms and screened for HPV. VIA triage arm: HPV-positive women were triaged using VIA, biopsied and received AT if VIA positive and eligible; no triage arm: eligible HPV-positive women received AT. Women ineligible for AT were referred to colposcopy. Women were asked about side effects immediately and 1 week after AT. Retention to screening and treatment algorithms was compared between arms.

resultsA total of 350 women [275 HIV-uninfected and 75 women living with HIV, (WLWH)] were allocated to receive HPV testing with VIA triage (n = 175) or no triage (n = 175). HPV prevalence was 28% [95% confidence interval (CI) = 23-33]; WLWH: 52% (95% CI = 40-64) versus HIV-uninfected: 21% (95% CI = 17-27; P < 0.05). Among women who underwent VIA triage with histologic diagnosis, 3/17 were VIA negative with cervical intraepithelial neoplasia (CIN)2+; 14/18 were VIA positive with <CIN2. Retention to screening and treatment algorithms was high (92%).

conclusionsThis pilot demonstrated the feasibility of implementing screening and treatment algorithms, including performing triage and treatment in one visit; however, VIA triage did not reduce overtreatment and missed some precancerous lesions. IMPACT: This study reports on implementation feasibility of two World Health Organization screening and treatment algorithms (with/out VIA triage). Although the retention to screening and treatment algorithms was high in both arms, the question of how best triaging HPV-positive women deserves further consideration, particularly for WLWH. See related In the Spotlight, p. 763.

Indexed as

AlgorithmsEarly Detection of CancerPapillomavirus InfectionsUterine Cervical NeoplasmsAdultColposcopyFemaleHuman Papillomavirus VirusesHumansMiddle AgedPapillomaviridaePilot ProjectsSouth AfricaTriageUterine Cervical Dysplasia

Identifiers

PMID37955560
PMCPMC11145165
OpenAlexW4388630009

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.