title: The current position and the future perspectives of cervical cancer screening.
abstract: Cervical screening programs for detecting cancer and precancer have dramatically reduced the incidence and mortality rates of cervical cancer since the 1960s. The efficacy of the screening programs depends on participation and the accuracy of the screening tests. Unfortunately, the participation rates are suboptimal; more than half the women with cervical cancer have not or have only sporadically been screened. Increasing participation is the best way of maximizing the program's benefit. Furthermore, cytology screening lacks high sensitivity for high-grade cervical intraepithelial neoplasia (≥CIN2). High-risk human papillomavirus (hrHPV) screening is more sensitive in the detection of cervical intraepithelial neoplasia than cytology screening, but less specific, so that additional triage testing is still mandatory. The aim of this article is to reflect on the efficacy of current cervical cancer screening and on promising future screening strategies with primary hrHPV testing and additional triage strategies for hrHPV-positive screening results.
authors.affiliation: Department of Obstetrics and Gynaecology, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
authors.forename: Remko P
authors.initials: RP
authors.lastname: Bosgraaf
authors.forename: Albert G
authors.initials: AG
authors.lastname: Siebers
authors.forename: Joanne A
authors.initials: JA
authors.lastname: De Hullu
authors.forename: Leon F A G
authors.initials: LF
authors.lastname: Massuger
authors.forename: Johan
authors.initials: J
authors.lastname: Bulten
authors.forename: Ruud L M
authors.initials: RL
authors.lastname: Bekkers
authors.forename: Willem J G
authors.initials: WJ
authors.lastname: Melchers
mesh_terms: D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis; D010342:Patient Acceptance of Health Care; D011230:Precancerous Conditions / Q000175:diagnosis / Q000473:pathology; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology