Cervical Cancer Screening—Past, Present, and Future

Abstract Cervical cancer screening has undergone a transformation in recent decades. Historically, programs were based on cervical cytology (i.e., “Pap smear”), which had to be repeated often because of its limited sensitivity and reproducibility. In more years, the discovery human papillomavirus (HPV) as necessary cause virtually all cancers led introduction HPV testing into clinical practice, first triage test for minor cytologic abnormalities, then conjunction with (cotesting), most recently, standalone test. Multiple randomized trials have shown that HPV-based higher compared cytology, providing great reassurance against precancer women HPV-negative many years. Analyses also been conducted support U.S. Preventive Services Task Force guidelines show primary achieves greatest balance benefits harms other strategies. An added benefit is ability conduct it from self-collected samples, critical extending coverage among hard-to-reach individuals could provide safe effective alternative in-person visits during COVID-19 pandemic. See related article by Liang et al., p. 474