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  CERVICAL CANCER / MULTINATIONAL CROSS-SECTIONAL STUDIES TO EVALUATE THE PERFORMANCE OF SCREENING TESTS

The diagnostic properties of various screening tests such as VIA, VIAM, VILI, cytology and HPV testing to detect high-grade cervical precancerous lesions (HSIL) is evaluated in several cross-sectional studies. 11 studies have been established in India (Mumbai, Jaipur, Kolkata, Trivandrum), Congo (Brazzaville), Mali (Bamako), Niger (Niamey), Guinea (Conakry) and Burkina-Faso (Ouagadougou). Each study aims to recruit around 5,000 women. The screening tests are provided by trained nurses, health workers or graduates. These studies provide a unique opportunity to assess the diagnostic properties of the tests based on a large sample of women by pooling the data. Since the tests are carried out by different types of health care providers in different study locations, the results may reflect the performance of tests in real life conditions.

All the recruited women in these studies are subjected to colposcopy and, biopsy, depending upon colposcopy findings. This will allow unbiased, direct estimation of the diagnostic properties of the tests. These studies have provided an opportunity to organise outlets of cervical cancer prevention services in the health services of 6 countries where these services did not exist. They have also provided a focal point of training human resources in cervical cancer prevention in these countries.

To date, 55,000 women aged 25 to 65 have been recruited (of whom around 82% are in the age range 30-49). A total of 1063 women were diagnosed with CIN 2-3 lesions in these studies, yielding a detection rate of 19 per 1000.

Details about these studies are given here.



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