Screening for Cervical Cancer

Abstract

Cervical cancer continues to be a major health problem in the developing world, where screening is not universal. Exfoliative cervical cytology or the Pap test is the primary tool in screening for cervical cancer. The Pap smear is effective in the diagnosis of preinvasive cervical carcinoma. The incidence of invasive cervical carcinoma has been reduced by 75% from 1950 to 1990 as a result of cervical cancer screening. The Pap smear is recommended annually for all women starting at age 18 or the age at the onset of sexual activity. Cervical cancer is associated with human papillomavirus infection and is considered a sexually transmitted disease. There is a strong correlation between cervical cancer and high-risk behaviors such as multiple sexual partners and early onset of sexual activity. Immunosuppressed status confers increased risk of cervical neoplasia and more fre?quent screening is recommended in these patients. Patients with an abnormal Pap smear should be referred to a physician with expertise in colposcopy. Cervical cancer when diagnosed in early stages is 90% cur?able and such patients should be referred to a gynecologic oncologist for appropriate management.