Screening for cervical cancer: different problems in the developing and the developed world

Cervical cancer incidence and mortality has been reduced by effective screening programmes particularly in British Columbia and the Nordic countries. There remains two outstanding problems. The first is over-treatment of dysplasia in the developed world. However, in the developing world cervical cancer is the most important female cancer. In these countries the Western model of cytology based screening is impractical and inappropriate. New strategies of better health education and novel methods of screening such as visual inspection are the most cost-effective means of reducing mortality from this cancer.