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To address the value of visual inspection where HPV‐based screening is not yet available, the study evaluated the real‐world effectiveness of visual inspection with acetic acid (VIA) and with Lugol’s iodine (VILI) as a primary screening method for cervical cancer in rural China. The VIA/VILI positivity rate, biopsy rate and detection rate of CIN2+ in the second round were significantly lower than in the first round. Multiple rounds of visual inspection with continuous training and quality assurance could act as a temporarily substitutional screening method for cervical cancer in resource‐restricted settings.
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