Screening for cervical cancer

It is well accepted that conscientious and widespread use of cervical cytology will significantly decrease the incidence and mortality rates of cervical cancer. The Papanicolaou smear for cervical cytology fulfills all the criteria for an ideal screening test. Not only is it cost effective, acceptable to most patients, and adaptable to widespread screening, it is sensitive enough to detect preinvasive disease resulting in decreased morbidity and mortality. Nevertheless, in developing countries cervical cancer still occurs at epidemic proportions, where an estimated 460,000 new cases per annum will be diagnosed, a significant proportion of which will be in advanced stages. First world notions pertaining to screening have proved unrealistic for the developing health care system of third world nations. This article provides an overview of screening for cervical cancer and considers cytological smearing, cervicography and direct visualization of the cervix, be it without or with the application of 4 percent acetic acid.