Strategies to promote screening for cancer of the uterine cervix

Screening for cervical cancer using the Papanicolaou smear, or Pap test, is now accepted as a key factor in the prevention of cervical cancer. Evidence from case-control and correlation studies indicates that cervical screening and treatment of pre-cursor lesions can reduce the incidence of invasive carcinoma. It has been estimated that up to 90% of invasive cervical cancer could be prevented if all at-risk women were screened at three-yearly intervals. However, the potential benefits of cervical screening are not being achieved fully in many western countries. It has been argued that the success of cervical screening programmes is largely dependant upon the proportion of the population who have been screened (population coverage). In many countries the population coverage achieved by the existing cervical screening programmes is less than optimal. In Australia it is estimated that less than 75% of eligible women have had a Pap smear in the past three years. Screening rates are lowest in those age ranges which are most at-risk of developing cervical carcinoma, and the majority of women who develop invasive carcinoma of the cervix have not been screened within recent years.