Is there a role for screening by cervicography in Australia?

A review of published studies that have evaluated cervicography as a screening-test for the presence of cervical cancer is presented. Significant problems with the use of cervicography at a population level can be anticipated, in particular, a high proportion of women with uninterpretable test-results and an unacceptably-low positive predictive value. Colposcopy was unable to distinguish adequately the true status of many women with suspicious cervicograms; half the women with a cervicogram that was suggestive of cancer and an abnormal result by colposcopy had normal or benign histological findings. The impact of cervicography on the morbidity and mortality of cervical cancer is unproved. On current evidence, cervicography would not appear to be suitable for use as a screening-test, either as a replacement for, or as a supplement to, the Papanicolaou smear-test.