Osmanabad cervical screening trial (HPV testing vs cytology vs VIA)
One round of HPV testing in rural Indian villages halved deaths from cervical cancer within eight years, while a Pap smear or a visual check did not, which is why HPV tests are now the world's preferred screen.
Overview
131,746 women aged 30 to 59 in 52 village clusters were randomised to HPV testing (34,126), cytology (32,058), visual inspection with acetic acid (34,074) or standard care (31,488). In the HPV arm there were 39 advanced cancers versus 82 in the control group (hazard ratio 0.47; 95% CI 0.32-0.69) and 34 cervical cancer deaths versus 64 (hazard ratio 0.52; 95% CI 0.33-0.83); neither cytology nor visual inspection significantly reduced advanced cancers or deaths, and adverse events occurred in 0.1% of screened women. The result made a single round of HPV testing the evidence base for WHO's HPV-first screening recommendation and for India's own screening guidance.
- HPV testing: 34 deaths; Control: 64 deaths.
- Put another way, the treated group had about 48 percent lower chance of the event at any given time (hazard ratio 0.52, likely range 0.33 to 0.83).
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Cluster-randomised trial in 52 villages of Osmanabad district, Maharashtra: one round of HPV DNA testing, cytology, visual inspection with acetic acid, or usual care in women aged 30-59. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Pages like this
not linked directly; found by shared links- PersonSurendra Shastri
Shares Mumbai VIA cervical screening trial (Tata Memorial), Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV screening for cervical cancer in rural India (Osmanabad), HPV DNA testing and self-sampling.
- PersonJade Goody
Shares Colposcopy and excisional treatment (LEEP/LLETZ, cone), HPV DNA testing and self-sampling, Prevention we already have is not deployed, The hardest cancers are found late.
- InstitutionICMR-National Institute of Cancer Prevention and Research
Shares HPV DNA testing and self-sampling, International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, The hardest cancers are found late.
- Key paperEffect of screening on oral cancer mortality in Kerala, India
Shares Rengaswamy Sankaranarayanan, International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, The hardest cancers are found late.
- TrialIARC India HPV vaccine dose study (one, two or three doses)
Shares Rengaswamy Sankaranarayanan, International Agency for Research on Cancer (IARC / WHO), Tata Memorial Centre, Prevention we already have is not deployed.
- TrialKerala oral cancer visual screening trial (Trivandrum)
Shares Rengaswamy Sankaranarayanan, International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, The hardest cancers are found late.
- IdeaSwitch every country to single-dose HPV vaccination and add catch-up to age 26
Shares International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, Most of the world has almost no cancer care, Cervical cancer.
- IdeaEliminate infection-caused cancers: HPV, hepatitis B and C, H. pylori and EBV
Shares International Agency for Research on Cancer (IARC / WHO), Prevention we already have is not deployed, Most of the world has almost no cancer care, Cervical cancer.