New Evidence on the Impact of Cervical Cancer Screening and Treatment Using HPV DNA Tests, Visual Inspection or Cytology
At the same time, studies have noted some challenges with VIA, including assuring consistent quality control and the fact that differing results have been obtained in differing settings.
New study raises questions
The new study, which followed more than 130,000 women for eight years in the Osmanabad district of India, found that a program strategy based on a single round of HPV testing was associated with approximately 50 percent reduced risk of cervical cancer incidence and mortality, whereas strategies based on a single round of VIA or Pap screening had little, if any, effect on cervical cancer rates and mortality.
While the results related to HPV testing are not surprising, the results related to VIA and Pap vary significantly from other studies and from experience with Pap screening programs over the years. It is generally accepted that Pap programs have had significant impact on cervical cancer rates in high-resource settings over the past several decades (with, presumably, the relatively low sensitivity of Pap smears being balanced by repetition of the tests many times during a woman’s life).
A number of studies have suggested equivalent or greater sensitivity of VIA compared with Pap tests.
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