ArticleNature medicine2023
Benefits, harms and cost-effectiveness of cervical screening, triage and treatment strategies for women in the general population.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 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
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- A bibliometric analysis and visualization of trends in cervical cancer screening technologies based on dual-database analysis.Frontiers in oncology · 2026Pooled it
- Resource-Adapted Triage Strategies for Women Testing HPV Positive With Self-Collected Vaginal Samples in Cameroon.International journal of cancer · 2026Article
- Chrysin treatment is associated with altered microrna expression and reduced levels of HPV16 E6 protein in caski cervical cancer cells.Medical oncology (Northwood, London, England) · 2026Article
- Experimental Analysis of HPV16 L1/L2 Chimeric VLP Internalization by Human Peripheral Blood Leukocytes.International journal of molecular sciences · 2026Article
- MiR-4327 targets TP53 to promote cervical cancer cell proliferation.Functional & integrative genomics · 2026Article
- Human Papillomavirus Infection Across the Immunological Spectrum: Clinical Expression, Colposcopic Challenges, and Therapeutic Implications.Diagnostics (Basel, Switzerland) · 2026Review
- AGPAT family members act as potential predictive biomarkers and therapeutic targets in cervical cancer.Discover oncology · 2026Article
- Cervical Cancer and Sexually Transmitted Infections Screening Among Individuals with a Substance Use Disorder: A Retrospective Cohort Study.Population health management · 2026Article
- Modelling the epidemic dynamics of HPV among women in China and optimization of ongoing cervical cancer elimination strategies.BMC medicine · 2026Article
- Opportunistic and Organized Cervical Cancer Screening: Impact on Lesion Severity and Surgical Outcomes in 9830 Cervical Conizations.Diagnostics (Basel, Switzerland) · 2026Article
- Article
- A guide to cancer screening.Nature reviews. Clinical oncology · 2026Review
- Minimal benefit of co-testing over HPV primary screening with cytology triage from resource-limited settings in China.Communications medicine · 2026Article
- The diagnostic value of colposcopy in postmenopausal women: a retrospective study.BMC women's health · 2026Article
- 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
- Comparison of ThinPrep cytology and high-risk human papillomavirus testing with different triage protocols for cervical cancer screening.American journal of translational research · 2026Article
- Article
- Readiness to transition to HPV self-collection from VIA screening: a mixed methods health systems assessment from Tamil Nadu, India.BMC health services research · 2025Article
- Scalable long-read nanopore HPV16 amplicon-based whole-genome sequencing.Scientific reports · 2025Article
- Advances in biomonitoring technologies for women's health.Nature communications · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 9 institutions in 8 countries.
Funding
Abstract
In 2020, the World Health Organization (WHO) launched a strategy to eliminate cervical cancer as a public health problem. To support the strategy, the WHO published updated cervical screening guidelines in 2021. To inform this update, we used an established modeling platform, Policy1-Cervix, to evaluate the impact of seven primary screening scenarios across 78 low- and lower-middle-income countries (LMICs) for the general population of women. Assuming 70% coverage, we found that primary human papillomavirus (HPV) screening approaches were the most effective and cost-effective, reducing cervical cancer age-standardized mortality rates by 63-67% when offered every 5 years. Strategies involving triaging women before treatment (with 16/18 genotyping, cytology, visual inspection with acetic acid (VIA) or colposcopy) had close-to-similar effectiveness to HPV screening without triage and fewer pre-cancer treatments. Screening with VIA or cytology every 3 years was less effective and less cost-effective than HPV screening every 5 years. Furthermore, VIA generated more than double the number of pre-cancer treatments compared to HPV. In conclusion, primary HPV screening is the most effective, cost-effective and efficient cervical screening option in LMICs. These findings have directly informed WHO's updated cervical screening guidelines for the general population of women, which recommend primary HPV screening in a screen-and-treat or screen-triage-and-treat approach, starting from age 30 years with screening every 5 years or 10 years.
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Registered trials
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.