Acceptability and Concordance of Self- Versus Clinician- Sampling for HPV Testing among Rural South Indian Women
Open accessAbstract
BACKGROUND: Despite being largely preventable, HPV-related cervical cancers continues to be the second highest cause of cancer deaths among Indian women. HPV testing using self-sampled samples may offer an opportunity to expand cervical cancer screening in India where there is currently a shortage of providers and facilities for cervical cancer screening. The study examines acceptability and concordance of self vs. clinician collected samples for HPV-relted cervical cancer screening among rural South Indian women. METHODS: Between May and August 2017, eight mobile screening clinics were conducted among 120 eligible women in rural villages in Mysore District, India. Women over the age of 30 underwent informed consent process and then self-sampled a sample for cervicovaginal HPV DNA testing. Next, the women underwent clinical exam where the clinician collected a cervicovaginal HPV DNA sample. Following the clinical exam, all participants answered an interviewer-administered questionnaire to assess their history of cervical cancer screening and acceptability of self- and clinician-sampling methods. To assess diagnostic accuracy, concordance of self- and clinician-sampled HPV DNA specimens was calculated in addition to five measures of acceptability (feeling of caring, privacy, embarrassment, genital discomfort, and genital pain). RESULTS: Study participants had a median age 39 years, about four-in-ten (41.7%) had a secondary education or above, the vast majority (87.5%) were married and only 3.4% reported having screened for cervical cancer. For all measures of participant acceptability, self-sampling was rated significantly higher than clinician-sampling. Cohen's kappa was 0.73 (95% CI: 0.34, 1.00), indicating substantial agreement between self- and clinician-sampling. CONCLUSION: This study demonstrates that HPV self-sampling for cervical cancer screening is feasible and acceptable in a community setting among South Indian rural women. Concordance between self-sampling and clinician-sampling was adequate for screening in community settings. .
AI snapshot
Written from the paper’s full text.
TL;DR
Among 120 rural South Indian women attending mobile screening clinics, self-sampling for HPV DNA testing was significantly more acceptable than clinician-sampling on all five measures and showed substantial agreement with clinician-collected samples (κ=0.735). The authors conclude self-sampling is feasible and acceptable for community-based cervical cancer screening in this setting.
Key findings
- Self-sampling was rated significantly more favorable than clinician-sampling for all five acceptability measures (all p<0.05); the largest difference was genital pain (mean 3.42 vs 2.85), and the smallest was feeling cared for (3.57 vs 3.46).
- Among 119 women with results, concordance was substantial: Cohen’s kappa 0.735 (95% CI 0.342, 1.0), total agreement 94.1% (95% CI 88.1, 97.3); self-sampling sensitivity was 66.7% (95% CI 42.8, 90.6) and specificity 98.1% (95% CI 95.5, 100.0) against clinician-sampled endocervical swabs.
- HPV DNA positivity was 12.6% (15/119) for clinician-sampled samples and 10.1% (12/119) for self-sampled samples.
- Preferences: 59.3% preferred self-sampling, 84.8% preferred a female provider; among respondents, 100% said they would test with self-sampling again and recommend it to a friend.
Methods
- Cross-sectional study conducted through eight mobile screening clinics in rural villages of Mysore District, Karnataka, India; 120 women aged ≥30 years who had not been screened for cervical cancer in the last three years and could consent were enrolled. Exclusions included hysterectomy, current menstruation, pregnancy, or cervical cancer diagnosis. The Methods state data collection occurred May–August 2018, while the abstract states May–August 2017.
- Participants self-collected a vaginal swab with a cervical brush, then a clinician collected an endocervical specimen; both were tested with the digene Hybrid Capture 2 HPV DNA Test detecting 13 high-risk HPV types. Acceptability was assessed by interviewer-administered Likert scale (1 least favorable to 5 most favorable) for five measures.
- Analysis included summary statistics, paired t-test or Wilcoxon signed-rank test, Cohen’s kappa, sensitivity, specificity, predictive values, and total agreement, with α=0.05; Stata 11.2 and R 3.6.2 were used.
Limitations
- Stated by the paper: small pilot sample; possible self-selection and limited generalizability; possible information bias because acceptability data were collected by interviewer-administered survey.
- Evident from the text: the abstract and Methods disagree on the data collection year (2017 vs 2018); self-sampling sensitivity was 66.7% with a wide 95% CI (42.8–90.6), and the study was cross-sectional and single-region.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
6 of 20 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Several studies comparing HPV screening results from self-collected and clinician-collected specimens in low- and middle-income countries have all demonstrated high levels of agreement.
“There have been several studies comparing HPV screening results from self-collected and clinician-collected specimens in low- and middle-income countries with all demonstrating high levels of agreement (Bhatla et al., 2009; Quincy et al., 2012; Verma and Khanna, 2013; Nilyanimit et al., 2014; Rosenbaum et al., 2014; Adamson et al., 2015; Ma’som et al., 2016).”
Quote in the paperSubstantial claim1 of 3 sources checked - Premisecitation
HPV testing has an overall sensitivity of 80-95% for detecting high-grade cervical intraepithelial neoplasia, compared to 60-80% for cytologic testing.
“A meta-analysis found an overall sensitivity of 80-95% for HPV testing compared to 60-80% for cytologic testing, and an overall specificity of 50-70% for HPV testing compared to 85-95% for cytologic testing (Sahasrabuddhe et al., 2012).”
Quote in the paperSubstantial claim1 of 1 sources checked- cites Sahasrabuddhe et al., 2012 source
The “Suitable Screening and Prevention Technologies for LMICs” section describes HPV DNA testing as highly accurate, but gives no sensitivity figures for HPV or cytologic testing. Searches for the stated ranges, a meta-analysis, and sensitivity for high-grade cervical lesions found no passage in our copy establishing the comparison. (LLM, conf=0.75)
Experimental — accuracy not yet measured
- Premisecitation
This study is one of the few studies that examined the usefulness of self-sampled swabs for cervical cancer screening in rural India.
“This is also one of the few studies that examined the usefulness of self-sampled swabs for cervical cancer screening in rural India (A Peedicayil et al., 2016; Adsul et al., 2019).”
Quote in the paperNot a substantial claim1 of 2 sources checked - Findingown data
Cohen's kappa value for agreement between self-sampling and clinician-sampling was 0.735 (95% CI 0.342, 1.0).
“The Cohen’s kappa value was 0.735 (95% CI: 0.342, 1.0) (Table 2).”
Quote in the paperSubstantial claim- Rests on an assumption: The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
- Findingown data
All respondents said they would recommend self-sampling to a friend.
“All said that they would test with self-sampling method again and recommend self-sampling to a friend (Table 3).”
Quote in the paperSubstantial claim
- Findingown data
All respondents said they would test with self-sampling method again.
“All said that they would test with self-sampling method again and recommend self-sampling to a friend (Table 3).”
Quote in the paperSubstantial claim - Findingown data
Cohen's kappa for agreement between self- and clinician-sampling was 0.73 (95% CI: 0.34, 1.00).
“Cohen’s kappa was 0.73 (95% CI: 0.34, 1.00), indicating substantial agreement between self- and clinician-sampling.”
Quote in the paperSubstantial claim - Findingown data
About three-in-five (59.3%) of respondents preferred to self-sample for their HPV DNA test.
“about three-in-five (59.3%) preferred to self-sample for their HPV DNA test.”
Quote in the paperSubstantial claim - Findingown data
Overall prevalence of HPV DNA positivity in clinician-sampled endocervical swab samples was 12.6% (95% CI 7.7, 19.9).
“Overall prevalence of HPV DNA positivity in the clinician sampled endocervical swab samples was 12.6% (95%CI: 7.7, 19.9).”
Quote in the paperNot a substantial claim - Findingown data
Only 3.4% of study participants reported having screened for cervical cancer.
“only 3.4% reported having screened for cervical cancer.”
Quote in the paperSubstantial claim - Findingown data
The smallest difference between self-sampling and clinician-sampling acceptability was in how well cared for participants felt (mean 3.57 vs 3.46).
“The smallest difference was in how well cared for the participants felt (mean of 3.57 for self-sampled versus 3.46 for clinician-sampled)”
Quote in the paperNot a substantial claim - Findingown data
Overall agreement between self-sampling and clinician-sampling tests was 94.1% (95% CI 88.1, 97.3).
“The overall agreement between the two tests was 94.1% (95% CI: 88.1, 97.3).”
Quote in the paperSubstantial claim- Rests on an assumption: The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
- Findingown data
The vast majority (84.8%) of respondents preferred a provider of the same gender for pelvic examinations.
“The vast majority (84.8%) of respondents preferred to have a provider of the same gender for their pelvic examinations”
Quote in the paperNot a substantial claim - Findingown data
For all measures of participant acceptability, self-sampling was rated significantly higher than clinician-sampling.
“For all measures of participant acceptability, self-sampling was rated significantly higher than clinician-sampling.”
Quote in the paperSubstantial claim - Findingown data
The largest difference between self-sampling and clinician-sampling acceptability was in whether the test caused genital pain (mean 3.42 vs 2.85).
“while the largest difference was in whether the test caused genital pain (mean of 3.42 for self-sampling versus 2.85 for clinician-collected) (Table 4).”
Quote in the paperNot a substantial claim - Findingown data
Self-sampled vaginal swab had greater specificity than sensitivity for HPV DNA testing compared with clinician-sampled endocervical swab.
“The self-sampled vaginal swab, when compared to the gold standard of the clinician-sampled endocervical swab for HPV DNA testing, had a greater specificity (98.1%; 95% CI: 95.5, 100) than it did sensitivity (66.7%; 95% CI: 42.8, 90.6).”
Quote in the paperNot a substantial claim- Rests on an assumption: The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
- Findingown data
Self-sampled vaginal swab had sensitivity 66.7% (95% CI 42.8, 90.6) for HPV DNA testing compared with clinician-sampled endocervical swab as gold standard.
“| Sensitivity | 66.7 | 42.8, 90.6 |”
Quote in the paperSubstantial claim- Rests on an assumption: The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
- Findingreasoning
Self-sampled swabs were acceptable to a substantial group of rural women.
“Thus, self-sampled swabs were acceptable to a substantial group of rural women and were reliable in terms of the detection of HPV DNA making them one of the preferred methods to be used in population based surveillance of reproductive cancers such as cervical cancer.”
Quote in the paperSubstantial claim - Findingown data
Laboratory assessments of both modes of sample collection revealed high concordance when comparing specimens collected by self-sampling and clinician-collected swabs.
“Furthermore, the laboratory assessments of both modes of sample collection revealed high concordance when comparing specimens collected by self-sampling and clinician-collected swabs.”
Quote in the paperSubstantial claim - Findingown data
Self-sampled swabs were reliable in terms of the detection of HPV DNA.
“Thus, self-sampled swabs were acceptable to a substantial group of rural women and were reliable in terms of the detection of HPV DNA making them one of the preferred methods to be used in population based surveillance of reproductive cancers such as cervical cancer.”
Quote in the paperSubstantial claim - Interpretationreasoning
A self-sampling option may be appealing to women that would otherwise not screen.
“A self-sampling option may be appealing to women that would otherwise not screen.”
Quote in the paperSubstantial claim - Premisecitation
A recent systematic review of 37 self-collection studies from 24 countries found overall high acceptability.
“A recent systematic review of 37 self-collection studies from 24 countries found overall high acceptability (Nelson et al., 2017).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Nelson et al., 2017 source
- Interpretationreasoning
Using self-collected samples to rule out HPV infection can reduce missed opportunities for screening in rural India.
“By using self-collected samples to rule out HPV infection, it is possible to reduce missed opportunities for screening in rural India.”
Quote in the paperSubstantial claim - Premisecitation
A review of nine studies found that participation in a cervical cancer screening program increased from 8.7% to 39% when self-sampling was offered as a screening option.
“A review of nine studies found that participation in a cervical cancer screening program increased from 8.7% to 39% when self-sampling was offered as a screening option (Snijders et al., 2013).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Snijders et al., 2013
- Premisecitation
A review and meta-analysis of 21 studies did not detect a statistically significant difference in sensitivity of self-collected specimens compared to clinician-collected specimens.
“A review and meta-analysis of 21 studies did not detect statistically significant difference in sensitivity of self-collected specimens compared to clinician-collected specimens.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Snijders et al., 2013
- Interpretationown data
Agreement between self- and clinician-sampling was substantial.
“Cohen’s kappa was 0.73 (95% CI: 0.34, 1.00), indicating substantial agreement between self- and clinician-sampling.”
Quote in the paperSubstantial claim - Interpretationown data
Self-sampled HPV specimens have great potential to be used in community-based screening programs.
“Consistent with previous studies comparing self-sampled to clinician-collected specimens, we found that self-sampled HPV specimens have a great potential to be used in community-based, screening programs.”
Quote in the paperSubstantial claim - Interpretationown data
Concordance between self-sampling and clinician-sampling was adequate for screening in community settings.
“Concordance between self-sampling and clinician-sampling was adequate for screening in community settings.”
- Also stated in: § Discussion · plain
“Concordance between self-sampling and clinician-sampling was adequate for screening in community settings raising the possibility that large scale screening programs could reduce the burden of cervical cancer cases and deaths in India.”
Quote in the paperSubstantial claim - Also stated in: § Discussion · plain
- Premisecitation
The majority of studies in the review reported similar specificity for both sampling methods.
“The majority of studies in the review reported similar specificity for both sampling methods (Snijders et al., 2013).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Snijders et al., 2013
- Interpretationcitation
A self-sampling option can increase participation in cervical cancer programs in India and other low- and middle-income countries.
“Overall, current data suggest that a self-sampling option can increase participation in cervical cancer programs in India, and other low- and middle-income countries.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Snijders et al., 2013
- Interpretationreasoning
Due to the physical and psychological discomfort associated with the pelvic exam necessary for cytologic testing, self-sampling may be an acceptable alternative.
“Due to the physical and psychological discomfort associated with the pelvic exam necessary for cytologic testing, self-sampling may be an acceptable alternative.”
Quote in the paperSubstantial claim- Rests on an assumption: Physical and psychological discomfort is associated with the pelvic exam necessary for cytologic testing.
- Interpretationown data
Self-sampling of HPV specimens was a viable alternative to clinician-sampling.
“Clinically, the data suggested that self-sampling of HPV specimens was a viable alternative to clinician-sampling.”
Quote in the paperSubstantial claim - Interpretationreasoning
Self-sampled swabs are one of the preferred methods to be used in population based surveillance of reproductive cancers such as cervical cancer.
“Thus, self-sampled swabs were acceptable to a substantial group of rural women and were reliable in terms of the detection of HPV DNA making them one of the preferred methods to be used in population based surveillance of reproductive cancers such as cervical cancer.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The sample size was small.
“First, since this was a pilot study to evaluate the interest and acceptability of using self-sampling before rolling out the large screening program, the sample size was small.”
Quote in the paperSubstantial claim - Premisecitation
There is limited data on the use of self-sampling in India.
“While there have been reports of their successful use in Africa, Latin America and in developed countries, there is limited data of their use in India (Lazcano-Ponce et al., 2011; Rees et al., 2018).”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationreasoning
The findings may not be generalizable because women may have self-selected to participate.
“It is likely that women may have self-selected to participate in the study and hence the findings may not be generalizable.”
Quote in the paperNot a substantial claim
- May combine two claims. 10
- Classified as probably not a substantial claim. 16
- The quote only partly states this claim. 1
May combine two claims.
PremisecitationHPV DNA tests are easily reproducible and have higher sensitivity for detecting high-grade cervical intraepithelial neoplasia than cytological tests.
“Tests for HPV DNA are easily reproducible and have higher sensitivity for detecting high-grade cervical intraepithelial neoplasia than cytological tests (WHO; Sankaranarayanan et al., 2011; Bansil et al., 2014; Sankaranarayanan, 2014; Racey and Gesink, 2015).”
Quote in the paperSubstantial claim1 of 3 sources checked- cites WHO
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Sankaranarayanan et al., 2011
- cites Bansil et al., 2014 source
The Background reports 50% sensitivity for Pap smears detecting moderate to severe CIN or cancer, versus 84–100% for provider-collected and 66–88% for self-collected HPV-DNA tests. This supports the higher-sensitivity comparison, but the paper does not say that HPV-DNA tests are easily reproducible. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationA sample size of at least 100 subjects is consistent with recommendations for agreement studies.
“This was consistent with recommendations from McAlinden et al that sample sizes for agreement studies should include at least 100 subjects(McAlinden et al., 2011).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites McAlinden et al., 2011 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationHPV testing has an overall specificity of 50-70%, compared to 85-95% for cytologic testing.
“A meta-analysis found an overall sensitivity of 80-95% for HPV testing compared to 60-80% for cytologic testing, and an overall specificity of 50-70% for HPV testing compared to 85-95% for cytologic testing (Sahasrabuddhe et al., 2012).”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Sahasrabuddhe et al., 2012 source
The Suitable Screening and Prevention Technologies for LMICs section describes HPV DNA testing as accurate, but gives no specificity estimates or comparison with cytology. Searches for the stated percentages and for a meta-analysis of HPV-versus-cytology test performance found no passage in our copy supporting the claimed 50–70% and 85–95% ranges. The retrieved passages have no page numbers. (LLM, conf=0.72)
Experimental — accuracy not yet measured
May combine two claims.
Findingown dataFor each of five acceptability measures, self-sampling was significantly more favorable than clinician-sampling (all p-values <0.05).
“For each of the five measures of acceptability of self-sampling versus clinician-sampling, self-sampling was significantly more favorable than was physician collection (all p-values were less than 0.05).”
Quote in the paperSubstantial claimThe quote only partly states this claim.
Findingown dataSelf-sampled vaginal swab had specificity 98.1% (95% CI 95.5, 100) for HPV DNA testing compared with clinician-sampled endocervical swab as gold standard.
“| Specificity | 98.1 | 95.5, 100.0 |”
Quote in the paperSubstantial claim- Rests on an assumption: The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
May combine two claims.
Findingown dataThis study demonstrated that self-sampled swabs were preferred by a large number of women, especially when the instructions on collection were provided in a user friendly, non-judgmental manner.
“This study demonstrated that self-sampled swabs were preferred by a large number of women, especially when the instructions on collection were provided in a user friendly, non-judgmental manner.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
Study design and conductnone givenAny indeterminate index test or reference standard results were treated as missing.
“Any indeterminate index test or reference standard results were treated as missing.”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationPersistent HPV infection is associated with the vast majority of cervical cancer cases.
“Persistent HPV infection is associated with the vast majority of cervical cancer cases (WHO).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites WHO
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe study overrecruited by 20% to account for incomplete data and indeterminate test results.
“We overrecruited by 20% to account for incomplete data and ‘indeterminate’ test results.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S4 (based).
InterpretationreasoningThe self-sampling method addresses structural issues to resource constraints, lack of staff, and space to provide screening.
“The self-sampling method addresses structural issues to resource constraints, lack of staff, and space to provide screening.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenOnly women who were able to give informed consent were recruited to participate in the study.
“Only women who were able to give informed consent were recruited to participate in the study.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationThe World Health Organization recommends low-cost, culturally-acceptable alternatives to cytology such as HPV DNA testing.
“To address many of the barriers to cervical cancer screening, the World Health Organization recommends low-cost, culturally-acceptable alternatives to cytology such as Human Papillomavirus (HPV) DNA testing (WHO).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites WHO
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
Interpretationown dataHPV self-sampling for cervical cancer screening is feasible and acceptable in a community setting among South Indian rural women.
“This study demonstrates that HPV self-sampling for cervical cancer screening is feasible and acceptable in a community setting among South Indian rural women.”
- Also stated in: § Discussion · boosted
“In conclusion, this study demonstrates that HPV self-sampling for cervical cancer screening is feasible and acceptable in a community setting among South Indian rural women.”
Quote in the paperSubstantial claim- Also stated in: § Discussion · boosted
May combine two claims.
Interpretationown dataSelf-sampling of vaginal samples was feasible and acceptable to women living in rural India.
“The study has reiterated that self-sampling of vaginal samples was feasible and acceptable to women living in rural India.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataWomen in rural India preferred self-sampling and were comfortable with the process.
“In fact, they preferred self-sampling and were comfortable with the process.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S4 (based).
InterpretationreasoningHPV testing using self-sampled samples may offer an opportunity to expand cervical cancer screening in India where there is currently a shortage of providers and facilities for cervical cancer screening.
“HPV testing using self-sampled samples may offer an opportunity to expand cervical cancer screening in India where there is currently a shortage of providers and facilities for cervical cancer screening.”
Quote in the paperNot a substantial claim- Rests on an assumption: There is currently a shortage of providers and facilities for cervical cancer screening in India.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenThe study research protocol was reviewed and approved by the institutional ethics committees of Public Health Research Institute of India and University of California, Berkeley.
“The study research protocol was reviewed and approved by the institutional ethics committees of Public Health Research Institute of India and University of California, Berkeley.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductnone givenA sample size of 100 would result in a confidence interval estimated to be 0.05.
“The formula suggested that a sample size of 100 would result in a confidence interval estimated to be 0.05.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductnone givenMissing data were excluded from analyses and no imputation was performed.
“Missing data were excluded from analyses, that is, no imputation was performed.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataSelf-sampling for detection of high-risk HPV DNA had comparable performance and accuracy to clinician-sampling.
“This study found comparable performance and accuracy of self-sampling for detection of high-risk HPV DNA.”
Quote in the paperSubstantial claim- Rests on an assumption: The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll study staff were trained to administer the surveys in a non-judgmental manner.
“We used standardized tests to screen for HPV DNA and all study staff were trained to administer the surveys in a non-judgmental manner.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
InterpretationreasoningLarge scale screening programs could reduce the burden of cervical cancer cases and deaths in India.
“Concordance between self-sampling and clinician-sampling was adequate for screening in community settings raising the possibility that large scale screening programs could reduce the burden of cervical cancer cases and deaths in India.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenWe used standardized tests to screen for HPV DNA.
“We used standardized tests to screen for HPV DNA and all study staff were trained to administer the surveys in a non-judgmental manner.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThere might be information bias because acceptability information may be influenced by the fact that women were asked to respond to the survey by an interviewer.
“Second, it is possible that there might be information bias as the acceptability information may be influenced by the fact that the women were asked to respond to the survey by an interviewer.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
There is currently a shortage of providers and facilities for cervical cancer screening in India.
“HPV testing using self-sampled samples may offer an opportunity to expand cervical cancer screening in India where there is currently a shortage of providers and facilities for cervical cancer screening.”
The paper relies on this without support.
HPV testing does not require retesting or multiple visits from the patient.
“Unlike cytologic testing, HPV testing does not require retesting or multiple visits from the patient.”
The paper relies on this without support.
HPV testing offers an option for self-sampling where cytological testing does not.
“HPV testing also offers an option for self-sampling where cytological testing does not.”
The paper relies on this without support.
Indian women continue to be hesitant and shy about undergoing a pelvic exam culturally.
“Furthermore, Indian women continue to be hesitant and shy about undergoing a pelvic exam culturally.”
The paper relies on this without support.
Physical and psychological discomfort is associated with the pelvic exam necessary for cytologic testing.
“Due to the physical and psychological discomfort associated with the pelvic exam necessary for cytologic testing, self-sampling may be an acceptable alternative.”
The paper relies on this without support.
The acceptability questionnaire measures have been previously used in other HPV self-sampling studies.
“Measures used in the acceptability questionnaire have been previously used in other HPV self-sampling studies.”
The paper relies on this without support.
The clinician-sampled endocervical swab is the gold standard for HPV DNA testing.
“when compared to the gold standard of the clinician-sampled endocervical swab for HPV DNA testing”
The paper relies on this without support.
This was one of the first studies to examine the feasibility and acceptability of using self-sampling techniques in a community based setting in a rural area of India.
“Despite these limitations, this was one of the first studies to examine the feasibility and acceptability of using self-sampling techniques in a community based setting in a rural area of India.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Several studies in different countries have demonstrated self-sampling for HPV to be a cost effective, easy, feasible, and well-accepted method with high accuracy.
“Several studies in different countries have demonstrated self‐sampling for HPV to be a cost effective, easy, feasible, and well‐accepted method with high accuracy. 16 , 17”
From Acceptability and validity of <scp>HPV</scp> self‐sampling for cervical cancer screening among women living in different ecological settings in <scp>India</scp> (2025) · cites this paper as [17]
The Introduction (page not provided) cites high acceptability across studies in 24 countries, and the Discussion reports that self-sampling was feasible and acceptable in rural India, with accuracy comparable to clinician sampling. The paper describes HPV DNA testing as a low-cost option, but does not establish that self-sampling itself is cost-effective. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Study dates differ between Abstract and Methods
MinorThe Abstract places the mobile clinics in May-August 2017, while the Methods state that data were collected in May-August 2018.
“Between May and August 2017, eight mobile screening clinics were conducted among 120 eligible women in rural villages in Mysore District, India.”
“This was a cross-sectional study that collected data between May and August 2018.”
Never-screened percentage differs from Table 1
MinorThe Results state that 57.1% had never been screened, but Table 1 reports 64 participants (53.8%) in the "No" category for prior cervical cancer screening.
“About three-fifths of respondents (57.1%) reported having never been screened for cervical cancer.”
“| No | 64 (53.8) |”
Cites
Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012
Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D. M., Forman, D., & Bray, F. (2015) · International Journal of Cancer · doi:10.1002/ijc.29210 · Cited by 28,766 · cited 1× · see citing works
“Keywords: Screening cervical cancer- self-collection- self-sampling- India programs (Kamangar et al., 2006; Ferlay et al., 2015; Beddoe, 2019).”
Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis
Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., & Bray, F. (2019) · The Lancet Global Health · doi:10.1016/s2214-109x(19)30482-6 · Cited by 4,241 · cited 1× · see citing works
“Approximately 84% of cases and 88% of cervical cancer deaths occur in low- and middle-income countries (Randall and Ghebre, 2016; Arbyn et al., 2020).”
BackgroundKamangar, F., Dores, G. M., & Anderson, W. F. (2006) · Journal of Clinical Oncology · doi:10.1200/jco.2005.05.2308 · Cited by 3,434 · cited 1× · see citing works
“Keywords: Screening cervical cancer- self-collection- self-sampling- India programs (Kamangar et al., 2006; Ferlay et al., 2015; Beddoe, 2019).”
Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012
Stimpfel, M., & Virant‐Klun, I. (2016) · Journal of Cancer Stem Cell Research · doi:10.14343/jcscr.2016.4e1003 · Cited by 2,723 · see citing works
McAlinden, C., Khadka, J., & Pesudovs, K. (2011) · Ophthalmic and Physiological Optics · doi:10.1111/j.1475-1313.2011.00851.x · Cited by 436 · cited 1× · see citing works
“This was consistent with recommendations from McAlinden et al that sample sizes for agreement studies should include at least 100 subjects(McAlinden et al., 2011).”
MethodKamangar, F., Dores, G. M., & Anderson, W. F. (2023) · Journal of Clinical Oncology · doi:10.1200/jco.23.00864 · Cited by 329 · see citing works
Screening for Cancer in Low- and Middle-Income Countries
Sankaranarayanan, R. (2014) · Annals of Global Health · doi:10.1016/j.aogh.2014.09.014 · Cited by 296 · cited 3× · see citing works
“India with the world’s second largest population, also experiences a large proportion (27%) of the world’s cervical cancer deaths annually (Sankaranarayanan, 2014).”
Background(2012) · International Journal of Cancer · Cited by 265 · see citing works
Snijders, P. J. F., Verhoef, V. M. J., Arbyn, M., Ogilvie, G., Minozzi, S., Banzi, R., van Kemenade, F. J., Heideman, D. A. M., & Meijer, C. J. L. M. (2013) · International Journal of Cancer · doi:10.1002/ijc.27790 · Cited by 265 · see citing works
The acceptability of self-sampled screening for HPV DNA: a systematic review and meta-analysis
Nelson, E. J., Maynard, B. R., Loux, T., Fatla, J., Gordon, R., & Arnold, L. D. (2017) · Sexually Transmitted Infections · doi:10.1136/sextrans-2016-052609 · Cited by 252 · cited 1× · see citing works
“A recent systematic review of 37 self-collection studies from 24 countries found overall high acceptability (Nelson et al., 2017).”
BackgroundLazcano-Ponce, E., Lorincz, A. T., Cruz-Valdez, A., Salmerón, J., Uribe, P., Velasco-Mondragón, E., Nevarez, P. H., Acosta, R. D., & Hernández-Avila, M. (2011) · The Lancet · doi:10.1016/s0140-6736(11)61522-5 · Cited by 230 · cited 1× · see citing works
“While there have been reports of their successful use in Africa, Latin America and in developed countries, there is limited data of their use in India (Lazcano-Ponce et al., 2011; Rees et al., 2018).”
BackgroundBansil, P., Wittet, S., Lim, J. L., Winkler, J. L., Paul, P., & Jeronimo, J. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-596 · Cited by 184 · see citing works
Sowjanya, A. P., Jain, M., Poli, U. R., Padma, S., Das, M., Shah, K. V., Rao, B., Devi, R. R., Gravitt, P. E., & Ramakrishna, G. (2005) · BMC Infectious Diseases · doi:10.1186/1471-2334-5-116 · Cited by 155 · see citing works
Challenges in Prevention and Care Delivery for Women with Cervical Cancer in Sub-Saharan Africa
Randall, T. C., & Ghebre, R. G. (2016) · Frontiers in Oncology · doi:10.3389/fonc.2016.00160 · Cited by 150 · cited 1× · see citing works
“Approximately 84% of cases and 88% of cervical cancer deaths occur in low- and middle-income countries (Randall and Ghebre, 2016; Arbyn et al., 2020).”
BackgroundCervical Cancer Prevention in Low- and Middle-Income Countries: Feasible, Affordable, Essential
Sahasrabuddhe, V. V., Parham, G. P., Mwanahamuntu, M. H., & Vermund, S. H. (2012) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-11-0540 · Cited by 131 · cited 1× · see citing works
“A meta-analysis found an overall sensitivity of 80-95% for HPV testing compared to 60-80% for cytologic testing, and an overall specificity of 50-70% for HPV testing compared to 85-95% for cytologic testing (Sahasrabuddhe et al., 2012).”
Method(2011) · PubMed · Cited by 100 · see citing works
Bhatla, N., Dar, L., Patro, A. R., Kumar, P., Kriplani, A., Gulati, A., Iyer, V. K., Mathur, S. R., Sreenivas, V., Shah, K. V., et al. (2009) · Cancer Epidemiology · doi:10.1016/j.canep.2009.10.013 · Cited by 99 · cited 1× · see citing works
“…results from self-collected and clinician-collected specimens in low- and middle-income countries with all demonstrating high levels of agreement (Bhatla et al., 2009; Quincy et al., 2012; Verma and Khanna, 2013; Nilyanimit et al., 2014; Rosenbaum et al., 2014; Adamson et al., 2015; Ma’som…”
BackgroundRees, I., Jones, D., Chen, H., & Macleod, U. (2018) · Preventive Medicine · doi:10.1016/j.ypmed.2017.11.019 · Cited by 92 · cited 1× · see citing works
“While there have been reports of their successful use in Africa, Latin America and in developed countries, there is limited data of their use in India (Lazcano-Ponce et al., 2011; Rees et al., 2018).”
BackgroundBasu, P., Mahajan, M., Patira, N., Prasad, S., Mogri, S., Muwonge, R., Lucas, E., Sankaranarayanan, R., Iyer, S., Naik, N., et al. (2019) · BMC Public Health · doi:10.1186/s12889-018-6350-4 · Cited by 89 · cited 1× · see citing works
“The Indian ministry of Health and Family Welfare has been piloting cervical cancer screening programs in select states since November 2016 (Basu et al., 2019; Kedar et al., 2019).”
BackgroundElimination of cervical cancer: challenges for developing countries
Beddoe, A. M. (2019) · ecancermedicalscience · doi:10.3332/ecancer.2019.975 · Cited by 81 · cited 1× · see citing works
“Keywords: Screening cervical cancer- self-collection- self-sampling- India programs (Kamangar et al., 2006; Ferlay et al., 2015; Beddoe, 2019).”
Rosenbaum, A. J., Gage, J. C., Alfaro, K. M., Ditzian, L. R., Maza, M., Scarinci, I. C., Felix, J. C., Castle, P. E., Villalta, S., Miranda, E., et al. (2014) · International Journal of Gynecology & Obstetrics · doi:10.1016/j.ijgo.2014.02.026 · Cited by 65 · cited 1× · see citing works
“…with all demonstrating high levels of agreement (Bhatla et al., 2009; Quincy et al., 2012; Verma and Khanna, 2013; Nilyanimit et al., 2014; Rosenbaum et al., 2014; Adamson et al., 2015; Ma’som et Asian Pacific Journal of Cancer Prevention, Vol 22 975 DOI:10.31557/APJCP.2021.22.3.971 HPV…”
BackgroundInfluentialMa'som, M., Bhoo‐Pathy, N., Nasir, N. H., Bellinson, J., Subramaniam, S., Ma, Y., Yap, S. H., Goh, P., Gravitt, P. E., & Woo, Y. L. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-011022 · Cited by 61 · see citing works
Racey, C. S., & Gesink, D. (2015) · The Journal of Rural Health · doi:10.1111/jrh.12136 · Cited by 57 · cited 1× · see citing works
“Tests for HPV DNA are easily reproducible and have higher sensitivity for detecting high-grade cervical intraepithelial neoplasia than cytological tests (WHO; Sankaranarayanan et al., 2011; Bansil et al., 2014; Sankaranarayanan, 2014; Racey and Gesink, 2015).”
BackgroundAdamson, P. C., Huchko, M. J., Moss, A. M., Kinkel, H.-F., & Medina‐Marino, A. (2015) · PLoS ONE · doi:10.1371/journal.pone.0137299 · Cited by 55 · cited 1× · see citing works
“…high levels of agreement (Bhatla et al., 2009; Quincy et al., 2012; Verma and Khanna, 2013; Nilyanimit et al., 2014; Rosenbaum et al., 2014; Adamson et al., 2015; Ma’som et Asian Pacific Journal of Cancer Prevention, Vol 22 975 DOI:10.31557/APJCP.2021.22.3.971 HPV Self-Sampling in Rural…”
BackgroundInfluentialIndia launches plan for national cancer screening programme
Bagcchi, S. (2016) · BMJ · doi:10.1136/bmj.i5574 · Cited by 37 · cited 1× · see citing works
“The screening program required mandatory oral, breast, and cervical cancer screening for people over the age of 30 in 100 selected districts of India (Bagcchi, 2016).”
BackgroundQuincy, B. L., Turbow, D. J., & Dabinett, L. N. (2012) · Journal of Obstetrics and Gynaecology · doi:10.3109/01443615.2011.625456 · Cited by 36 · cited 1× · see citing works
“…and clinician-collected specimens in low- and middle-income countries with all demonstrating high levels of agreement (Bhatla et al., 2009; Quincy et al., 2012; Verma and Khanna, 2013; Nilyanimit et al., 2014; Rosenbaum et al., 2014; Adamson et al., 2015; Ma’som et Asian Pacific Journal…”
BackgroundAdsul, P., Srinivas, V., Gowda, S., Nayaka, S., Pramathesh, R., Chandrappa, K., Khan, A., Jayakrishna, P., & Madhivanan, P. (2019) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.12859 · Cited by 23 · see citing works
Self-citationKuriakose, S., Sabeena, S., Binesh, D., Abdulmajeed, J., Ravishankar, N., Ramachandran, A., Vijaykumar, B., & Ameen, N. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13116 · Cited by 19 · see citing works
Community Prevalence of Human Papillomavirus by Self-Collected Samples in South India
Peedicayil, A., Abraham, P., Prasad, J., Jeyaseelan, L., Abraham, S., Kurian, S., Gravitt, P., & Shah, K. V. (2016) · Indian Journal of Gynecologic Oncology · doi:10.1007/s40944-016-0045-5 · Cited by 17 · cited 1× · see citing works
“This is also one of the few studies that examined the usefulness of self-sampled swabs for cervical cancer screening in rural India (A Peedicayil et al., 2016; Adsul et al., 2019).”
BackgroundNilyanimit, P., Wanlapakorn, N., Niruthisard, S., Takahashi, M., Vongpunsawad, S., & Poovorawan, Y. (2015) · Asian Pacific Journal of Cancer Prevention · doi:10.7314/apjcp.2014.15.24.10809 · Cited by 16 · cited 1× · see citing works
“…low- and middle-income countries with all demonstrating high levels of agreement (Bhatla et al., 2009; Quincy et al., 2012; Verma and Khanna, 2013; Nilyanimit et al., 2014; Rosenbaum et al., 2014; Adamson et al., 2015; Ma’som et Asian Pacific Journal of Cancer Prevention, Vol 22…”
BackgroundHariprasad, R., Kedar, A., Kannan, R., et al. (2019) · Indian Journal of Community Medicine · doi:10.4103/ijcm.ijcm_268_18 · Cited by 16 · cited 1× · see citing works
“The Indian ministry of Health and Family Welfare has been piloting cervical cancer screening programs in select states since November 2016 (Basu et al., 2019; Kedar et al., 2019).”
BackgroundHuman papilloma virus vaccines
Verma, R. K., & Khanna, P. (2012) · Human Vaccines & Immunotherapeutics · doi:10.4161/hv.22063 · Cited by 12 · see citing works
SHULMAN, L. P. (2012) · Yearbook of Obstetrics Gynecology and Women s Health · doi:10.1016/j.yobg.2012.06.046 · Cited by 7 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Gennaro, G. D., Licata, F., Trovato, A., & Bianco, A. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1003461 · Cited by 69 · see citing works
Self-sampling for HPV testing in cervical cancer screening: A scoping review
Colonetti, T., Uggioni, M. L. R., dos Santos, A. L. M., Uggioni, N. M., Elibio, L. U., Balbinot, E. L., Grande, A. J., & da Rosa, M. I. (2024) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2024.02.032 · Cited by 32 · see citing works
Hariprasad, R., John, A., & Abdulkader, R. S. (2023) · JCO Global Oncology · doi:10.1200/go.22.00401 · Cited by 20 · see citing works
Creagh, N. S., Boyd, L. A. P., Bavor, C., Zammit, C., Saunders, T., Oommen, A. M., Rankin, N. M., Brotherton, J. M. L., & Nightingale, C. E. (2023) · JCO Global Oncology · doi:10.1200/go.22.00297 · Cited by 17 · see citing works
“Two studies compared practitioner-supported models with in-clinic collection versus mail-out or athome collection models (n = 1 at-home testing, n = 1 opt-out); higher uptake was reported in mail-out/athome testing models.(21,27) We note that in models that use a population-based mail-out approach, it is not always TA…”
BackgroundInfluentialLi, J., Wu, R., Qu, X., Huang, X., Li, L., Lin, Z., Zhang, Z., Deng, J., Liu, R., Zhao, X., et al. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.938272 · Cited by 16 · see citing works
Colling, A. M., Creagh, N. S., Gogia, N., Wyatt, K., Zammit, C. M., Brotherton, J. M. L., & Nightingale, C. E. (2024) · Health Expectations · doi:10.1111/hex.13961 · Cited by 14 · see citing works
Cross-Sectional Study of HPV Self-Sampling among Indian Women—A Way Forward
Anand, K., Mishra, G. A., Pimple, S. A., Biswas, S., Kulkarni, V., & Salunke, G. V. (2022) · Indian Journal of Medical and Paediatric Oncology · doi:10.1055/s-0042-1742642 · Cited by 13 · see citing works
“16,17,19 This strategy may not be feasible in human-resource-constrained countries like India.”
BackgroundResultHang, S., Haruyama, R., Uy, K., Fujita, N., Kimura, T., Kanal, K., & Kawana, K. (2023) · Journal of Gynecologic Oncology · doi:10.3802/jgo.2024.35.e6 · Cited by 11 · see citing works
“As in previous studies, most women felt that the instructions were easy to understand and could perform self-sampling with confidence, minor pain, and less embarrassment than clinician sampling [16,23].”
ResultOtieno, J. A., Were, L. M., Nyanchoka, M., Olwanda, E. E., Mulaku, M., Sem, X., Kohli, M., Markby, J. L., Muriuki, A., & Ochodo, E. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1439164 · Cited by 15 · see citing works
Mishra, G. A., Pimple, S. A., Anand, K. V., Kulkarni, V. Y., Patil, A. S., & Biswas, S. K. (2025) · International Journal of Cancer · doi:10.1002/ijc.35222 · Cited by 10 · see citing works
“16,17 Self-sampling has the advantage of not requiring a vaginal speculum examination, thus reducing the discomfort that may make screening unattractive, even among women who have access to health care.”
Implementation strategies of cervical cancer screening in South Asia: A systematic review
Sabeena, S., Ravishankar, N., & Kalpana, M. (2024) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.15366 · Cited by 10 · see citing works
Song, J., Ni, Y.-H., Fang, J., et al. (2024) · BMC Women s Health · doi:10.1186/s12905-024-03186-w · Cited by 8 · see citing works
“These findings are consistent with previous studies reporting mild pain and less embarrassment with self-sampling [27, 28].”
ResultOommen, A. M., Ashfaq, M., Cherian, A. G., Colling, A. M., Ramírez, A. T., Saunders, T., Singarayar, P., Thomas, V., Thomas, A., Marcus, T. A., et al. (2024) · Journal of Cancer Policy · doi:10.1016/j.jcpo.2024.100513 · Cited by 9 · see citing works
Venghateri, J. B., Nathani, P., Goyal, S., Sarang, B., Rawtani, H., Patil, P., Deepa, K. V., Jain, N., Gadgil, A., & Roy, N. (2025) · BMC Cancer · doi:10.1186/s12885-025-14859-6 · Cited by 8 · see citing works
Sangrajrang, S., Pitakkarnkul, S., Muwonge, R., Ploysawang, P., Pangmuang, P., Seeda, K., & Basu, P. S. (2023) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2023.24.8.2615 · Cited by 6 · see citing works
“…(kappa range: 0.70-0.88) between the self- and provider-collected sampling technics, especially when RT-PCR based assays were used (Bhatla et al., 2009; Boggan et al., 2015; Gravitt et al., 2001; Madhivanan et al., 2021; Obiri-Yeboah et al., 2017; Safaeian et al., 2007; Sowjanya et al., 2009).”
MethodInfluentialPanta, S., Rajaram, S., Heda, A., Bhadoria, A. S., Kalita, D., Chawla, L., & Chaturvedi, J. (2024) · Asian Pacific Journal of Cancer Prevention · doi:10.31557/apjcp.2024.25.2.653 · Cited by 6 · see citing works
“Furthermore, Indian women continue to be hesitant and shy about undergoing a pelvic exam culturally [12].”
BackgroundHuman papillomavirus self-sampling in Asia: a systematic review
Ji, X., Hao, M., Wang, Y., Kong, W., Pan, Z., Sun, Q., & Miao, J. (2025) · Frontiers in Microbiology · doi:10.3389/fmicb.2025.1540609 · Cited by 4 · see citing works
The effectiveness of an extra-curricular lecture for STI prevention and sexual education
Reinholz, M., Nellessen, T., Wei, E., et al. (2023) · Epidemiology and Infection · doi:10.1017/s0950268823000079 · Cited by 4 · see citing works
“Before the lecture, 96.9% had heard about HIV, 48.4% about genital herpes, 36.8% about syphilis, 30.5% had heard about chla-mydia, 23.9% about scabies, 22.4% about gonorrhoea, 17.7% about HPV and 16.7% about genital warts.”
InfluentialA qualitative study on ASHA workers’ perspective on HPV self-sampling in Sikkim India
Hariprasad, R., Srinivasan, M., Ravi, P., Tamang, H., Sharma, A., Pradhan, S., & Dhanasekaran, K. (2025) · Scientific Reports · doi:10.1038/s41598-025-87041-4 · Cited by 5 · see citing works
Dixit, R., Chakrawal, A., Purwar, R., & Pandey, M. (2026) · Gynecologic Oncology · doi:10.1016/j.ygyno.2026.05.019 · Cited by 3 · see citing works
Pärna, K., Nygård, M., Tisler, A., Toompere, K., Naaber, P., Ratnik, K., Ķīvīte‐Urtāne, A., Žodžika, J., Stankūnas, M., Baltzer, N., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069558 · Cited by 3 · see citing works
Beaverson, S., Cyrus, J. W. W., & Huffstetler, A. N. (2023) · Journal of Women s Health · doi:10.1089/jwh.2023.0125 · Cited by 3 · see citing works
Xue, S., Zeng, X., Li, J., Kang, L., Xi, M., Xu, L., Fu, P., Zhou, M., Ao, M., Yao, X., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1524796 · Cited by 2 · see citing works
Sarma, P., Barmon, D., Kumar, A., Kataki, A., Sarma, A., Baruah, U., Kakoti, L., Barman, D., & Sharma, R. (2024) · Cancer Reports · doi:10.1002/cnr2.70097 · Cited by 2 · see citing works
Experiences with HPV self-sampling in India: advancing cervical cancer prevention and screening
Anand, K., Mishra, G. A., Suryawanshi, V. B., Pimple, S. A., Kulkarni, V., & Vahabi, M. (2026) · BMC Public Health · doi:10.1186/s12889-026-26212-y · Cited by 2 · see citing works
NAMS task force report on cervical cancer
Bhatla, N. (2024) · Annals of the National Academy of Medical Sciences (India) · doi:10.25259/anams_tfr_11_2024 · Cited by 2 · see citing works
Human papillomavirus self-sampling for cervical cancer screening
Oak, A., Kannusamy, S., Pathak, R. S., & Dikshit, R. P. (2023) · Current Medicine Research and Practice · doi:10.4103/cmrp.cmrp_12_23 · Cited by 1 · see citing works
Rani, J., Abhilashi, K., Kumari, P., et al. (2022) · Journal of Indira Gandhi Institute Of Medical Sciences · doi:10.4103/jigims.jigims_18_22
Indarti, J., Syaharutsa, D. M., Surya, I. U., et al. (2024) · Indonesian Journal of Obstetrics and Gynecology · doi:10.32771/inajog.v12i2.2402
Tovar, A., Person-Rennell, N., Coronado, G. D., et al. (2026) · medRxiv · doi:10.64898/2026.05.01.26352235
Self-citationKigongo, E., Heaney, C., McBride, L., Gliga, G., & Burns, R. (2026) · BMC Public Health · doi:10.1186/s12889-026-27893-1 · Cited by 1 · see citing works
- Authors
- Madhivanan, P., Nishimura, H., Ravi, K., Pope, B., Coudray, M., Arun, A., Krupp, K., Jayakrishna, P., & Srinivas, V.
- Affiliations
- University of Arizona (US)
- Johns Hopkins University (US)
- Public Health Research Institute Of India (IN)
- University of Central Florida (US)
- ORCID
- Venue
- Asian Pacific Journal of Cancer Prevention
- Publisher
- EpiSmart Science Vector Ltd
- Published
- 2021-03-01
- Volume
- 22
- Issue
- 3
- Pages
- 971-976
- ISSN
- 1513-7368 (ISSN-L)
- 2476-762X
- PMC
- PMC8286674
- OpenAlex
- W3149836471
- Semantic Scholar
- bdaa7892453f9106377c2c38b4d9aa5ee5be5f21
- Cited by
- 31
- References
- 29
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 11 · 2023: 8 · 2022: 4
- FWCI
- 3.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Asian Pacific Journal of Cancer Prevention (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UA Campus Repository (The University of Arizona) (acceptedVersion, cc-by-nc)
- PubMed Central (submittedVersion, cc-by)
- Funders
- National Institutes of Health (TW010540)
- National Heart, Lung, and Blood Institute
- National Institute of Allergy and Infectious Diseases (R15 AI128714)
- Fogarty International Center (#TW010540, D43TW010540)
- National Institute on Minority Health and Health Disparities
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- HPV self-sampling, clinician-collected samples, cervical cancer screening, HPV testing, concordance, rural women, South India, cervical cancer prevention
- MeSH terms
- Self-Testing, Adult, Uterine Cervical Neoplasms, DNA, Viral, Female, Humans, India, Middle Aged, Patient Acceptance of Health Care, Physicians, Rural Population, Sensitivity and Specificity, Specimen Handling, Vaginal Smears, Papillomavirus Infections, Early Detection of Cancer, Gynecological Examination
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-16.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-16.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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