[Screening and early diagnosis of cervical cancer]

Because of the natural history of precancerous cervical lesions, cancer of the cervix uteri is easily preventable by screening. Pap smear is an effective and simple test, not very expensive and harmless. In France, 3000 to 3500 new cases still occur every year especially due to insufficient participation of the target population but also because of low sensibility of the test and problems in the management of cytological abnormalities. Organisation of screening, following the Alsatian model, which has been operational for 15 years, would be a cost-effective strategy. Changing Pap smear for HPV testing needs careful assessment by national population based randomized studies before any routine use.