Cervical cancer screening in developing countries

Abstract

Cervical cancer is the most common malignancy amongst females in developing countries, mainly due to a lack of precursor screening. This absence of screening is the result of inherent disadvantages of the Pap smear: high cost, low sensitivity, the need of a laboratory with high human expertise and a complex logistic system of a screening programme. The prerequisites for screening in a developing country include a screening method that is affordable which can be effectively applied once in a lifetime at the age of 30-35 years, provide an immediate result and thereby allow for on-site treatment of positive cases. None of the available screening methods comply with these prerequisites. More research is necessary into different combinations of tests, which improve sensitivity. On-site HPV identification, alone or in combination with other tests is promising. Another promising development is immunization against HPV infection, either as a preventative measure or for stimulating immunity in infected women.