The use of a reference standard consisting of colposcopy and directed biopsy served two purposes. The treatment decision was supposed to be based on colposcopic impression (with lab results coming later to identify any cancers that might have been missed) to reduce the number of visits and the loss to follow-up care. However, district hospital staff usually preferred to wait for the biopsy result to come back before offering treatment. Second, the use of colposcopy allowed comparison to conventional cytology and the evaluation of the proposed triage methods: VIA, VILI, and VIAM. Women for whom pregnancy was known or suspected.
