New Evidence on the Impact of Cervical Cancer Screening and Treatment Using HPV DNA Tests, Visual Inspection or Cytology
In the nine years since the inauguration of the ACCP, the partners have conducted studies comparing a number of screening techniques including cytology, visual inspection methods using acetic acid or Lugol’s iodine and an HPV DNA test. The tests were evaluated in over 20 low-resource settings around the world.
HPV DNA testing and VIA have proven to be of special interest. HPV testing has been shown to have better performance than either cytology or VIA for primary screening due to much higher test sensitivity. Furthermore, HPV testing has been coupled effectively with VIA for treatment triage. Both VIA and HPV testing have been successfully paired with cryotherapy — a relatively simple, inexpensive, and safe method of freezing affected cervical tissue.
Studies of VIA have reported sensitivity values comparable to or greater than Pap and have described advantages related to the need for fewer specialized personnel and less infrastructure, training, and equipment. Also, VIA provides immediate results, making it possible to screen and treat women during the same visit. This is important since inability to follow up with women for necessary treatment is a major cause of low program impact worldwide.
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