A prospective cohort study examining cervical cancer screening methods in HIV-positive and HIV-negative Cambodian women: a comparison of human papilloma virus testing, visualization with acetic acid, and digital colposcopy

Objectives: Logistical and economic issues make traditional cytology-based cervical cancer screening challenging in developing countries. Alternative, cost-effective, screening strategies must be developed to screen millions of women in resource poor countries such as Cambodia. Design: A prospective cohort study during which all women underwent four cervical cancer screening methods: 1) self-sampled human papilloma virus (HPV) testing (careHPVTM system) 2) clinician-collected HPV testing 3) visualization with acetic acid (VIA) 4) digital colposcopy (DC) with the Enhanced Visual Assessment System (EVA). Setting: A referral hospital in Phnom Penh, Cambodia. Participants: 250 Cambodian women (129 HIV+, 121 HIV-). Subjects were recruited from the National Center for HIV/AIDS Dermatology and sexually transmitted disease (STD) cohort, the Sihanouk Hospital Center of Hope’s Rural Outreach Teams, and the Pochentong Medical Center. Results: 56 of the 250 (22·4%) patients tested positive for hig...