New technologies in cervical cytology screening: A word of caution

Nearly 5000 women in the United States will die of cervical cancer this yea r and many of those deaths could be prevented. Most incident cases (60%) ar e associated with absent or deficient screening. Approximately 25% of scree ning failures are due to errors in cervical sampling or smear interpretatio n. New techniques for cytology screening such as liquid-based smears and co mputerized rescreening of slides are being promoted to physicians and the l ay public despite limited scientific evaluation. Improving the validity of screening tests is important, but shifting resources for this purpose might cause net harm if the result is fewer screening opportunities for high-ris k women. New screening technologies do not address this utilization gap and might widen it by driving the cost of screening out of the reach of high-r isk women. Greater decreases in cervical cancer morbidity and mortality wou ld likely result if the same resources were invested in a comprehensive nat ional screening program that targeted women at highest risk. (C) 1999 by Th e American College of Obstetricians and Gynecologists.