In 2009 Sankaranarayanan et al published their findings from a large cluster-randomized, controlled trial of a single round of HPV testing, cytology testing or visual inspection with acetic acid - with appropriate treatment for those confirmed positive - as interventions to decrease mortality from cervical cancer. The control arm did not receive any screening or treatment. Several issues are brought up through the approval and conduct of this trial, which was carried out among high-risk women in rural Maharashtra, India.