An up-dating on oncologic colpocytology

The mortality rate from cervical cancer has notably decreased above all in those places where aggressive Papanicolaou smear screening programmes have taken place. In other countries, where an organized screening programme has not taken place, there has been an increase in mortality from cervical carcinoma. Beyond the global effectiveness of cervical screening, the problem today is in the choice of women to be screened and the frequency of tests in women who have had previous negative results. In today's sexually permissive society many women are at risk for developing cervical cancer: therefore screening policies will need to be constantly reviewed to recruit, in the immediate future, most women into a screening programme (especially those between 35 and 65 who have never been screened). With regard to the problems of screening frequency, the annual interval would seem more adapted to today's society both because it has now become a habit for many women, and just because so many women are at risk. Centrally organized screening programmes, diffusion of colposcopy, improved clinical follow-up of patients (in case of abnormal cytologic and colposcopic findings) will undoubtedly contribute to better prevention.