<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Kate T Simms</style></author><author><style face="normal" font="default" size="100%">Adam Keane</style></author><author><style face="normal" font="default" size="100%">Nguyen, Diep Thi Ngoc</style></author><author><style face="normal" font="default" size="100%">Michael Caruana</style></author><author><style face="normal" font="default" size="100%">Michaela T Hall</style></author><author><style face="normal" font="default" size="100%">Gigi Lui</style></author><author><style face="normal" font="default" size="100%">Cindy Gauvreau</style></author><author><style face="normal" font="default" size="100%">Owen Demke</style></author><author><style face="normal" font="default" size="100%">M. Arbyn</style></author><author><style face="normal" font="default" size="100%">Partha Basu</style></author><author><style face="normal" font="default" size="100%">Wentzensen, Nicolas</style></author><author><style face="normal" font="default" size="100%">Beatrice Lauby-Secretan</style></author><author><style face="normal" font="default" size="100%">Andre Ilbawi</style></author><author><style face="normal" font="default" size="100%">Raymond Hutubessy</style></author><author><style face="normal" font="default" size="100%">Maribel Almonte</style></author><author><style face="normal" font="default" size="100%">de Sanjosé, Silvia</style></author><author><style face="normal" font="default" size="100%">Helen Kelly</style></author><author><style face="normal" font="default" size="100%">Shona Dalal</style></author><author><style face="normal" font="default" size="100%">Linda O Eckert</style></author><author><style face="normal" font="default" size="100%">Santesso, Nancy</style></author><author><style face="normal" font="default" size="100%">Broutet, Nathalie</style></author><author><style face="normal" font="default" size="100%">Canfell, Karen</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Benefits, harms and cost-effectiveness of cervical screening, triage and treatment strategies for women in the general population.</style></title><secondary-title><style face="normal" font="default" size="100%">Nat Med</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">Adult</style></keyword><keyword><style  face="normal" font="default" size="100%">Cervix Uteri</style></keyword><keyword><style  face="normal" font="default" size="100%">Child, Preschool</style></keyword><keyword><style  face="normal" font="default" size="100%">Cost-Benefit Analysis</style></keyword><keyword><style  face="normal" font="default" size="100%">Early Detection of Cancer</style></keyword><keyword><style  face="normal" font="default" size="100%">Female</style></keyword><keyword><style  face="normal" font="default" size="100%">Humans</style></keyword><keyword><style  face="normal" font="default" size="100%">Papillomavirus Infections</style></keyword><keyword><style  face="normal" font="default" size="100%">triage</style></keyword><keyword><style  face="normal" font="default" size="100%">Uterine Cervical Neoplasms</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2023</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2023 Dec</style></date></pub-dates></dates><volume><style face="normal" font="default" size="100%">29</style></volume><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;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.&lt;/p&gt;
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