[Screening for cervical cancer]

Cervical cancer incidence and mortality are falling off since the introduction of pap smear in the early 60's. In Belgium, however, there is no controlled screening politics. Oncogenic papillomaviruses are implicated in cervical cancer. Their identification is possible on thin layer technique, which allows the clinician to adapt his follow-up whether they are present or not, notably in case of borderline or low grade lesions. Cervical cancer is progressing slowly, the peak incidence happening more or less ten years after first lesions. Therefore, screening starting age, frequency and ending age are still debated. In Belgium, it is still not organised and may miss the most exposed populations. Furthermore, screening frequency is decreasing rapidly after age of 50 even though there is another incidence peak of cervical cancer at the age of 70. Pap smears' evolution in Belgium is unsure since there will be soon HPV vaccines available. But these will not be active against all oncogenic types and though they will be given to young girls before their first sexual experiences, the rest of the female population will require pap smear for a few years.