Cervical Cancer screening strategies

Introduction

Screening of women with the Papanicolaou (Pap) test has led to an important decrease in the incidence and mortality due to cervical cancer in countries where it has been systematically implemented. However, the results were significantly poorer in countries where the implementation was inefficient. On the other hand, a consensus has been reached on the direct relationship between HPV infection and cervical carcinogenesis. Therefore, HPV detection could be a reasonable alternative for the detection of precursor lesions that would progress to cancer if not treated. It has been demonstrated that HPV screening is more sensitive than the Pap test in the detection of high-grade transformative lesions and cancer, the main disadvantage being its low specificity.

Objective

  • Compare different cervical cancer screening strategies that involve the Pap test and/or the HPV test to the current screening standard to decide which of these strategies (if any) are to be chosen in a large-scale, efficient screening program.