Screening for cervical cancer
Screening is testing of all women at risk of cervical cancer, most of whom will be without symptoms.
Screening aims to detect precancerous changes, which, if not treated, may lead to cancer.
Screening is only effective if there is a well organized system for follow-up and treatment.
Women who are found to have abnormalities on screening need follow-up, diagnosis and possibly treatment, in order to prevent the development of cancer or to treat cancer at an early stage.
Several tests can be used in screening for cervical cancer. The Pap smear (cytology) is the only test that has been used in large populations and that has been shown to reduce cervical cancer incidence and mortality. Other tests (VIA, VILI, HPV) show promise but there is as yet no comparable evidence on their effectiveness. Large studies are still under way.
Regardless of the test used, the key to an effective programme is to reach the largest proportion of women at risk with quality screening and treatment.
Organized screening programmes designed and managed at the central level to reach most women at risk are preferable to opportunistic screening.