SCREENING - THE NEXT CENTURY

Background. Screening for cervical cancer and its precursors has tradi tionally been performed by Papanicolaou smear. As cost considerations have become more important and as developing countries have begun to i nitiate screening programs, other approaches to screening have been co nsidered. Methods. Proposed new methods potentially useful for screeni ng for cervical cancer and its precursors were reviewed. Results. Cerv ical cancer screening using unaided or aided visual approaches, human papillomavirus DNA testing and typing, cervical photography, and autom ated Pap smear screening instruments are all potentially valuable when used alone or in combination, depending on the country. Conclusions. New techniques will make it possible to screen high risk, low-income p opulations for cervical cancer and its precursors and to do so more co st-effectively than is possible using conventional Western approaches. In addition, the latest technology can enhance the screening methods traditionally used in industrialized countries and can increase the po sitive and negative predictive value of the screening method.