Cervical cancer prevention in the 21st century: cost is not the only issue

The wide publicity related to human papillomavirus (HPV) vaccines has led to a sense that HPV vaccine programs are inevitable in both developed and developing countries, whereas 2 existing methods of screening-visual inspection with ascetic acid (VIA) and DNA testing-have received much less attention. These screening methods detect cervical lesions better than does the Papanicolaou test and allow immediate treatment, minimizing loss to follow-up. These advantages may outweigh the strengths of HPV vaccines. Priority should be given to improving screening coverage with VIA and DNA tests, focusing on women older than 30 years and underserved populations in all countries. This approach will save the lives of millions of women who have already been exposed to HPV and will develop cervical cancer during the next 20 years.