Secondary prevention of cervical cancer

Best Pract Res Clin Obstet Gynaecol. 2018 Feb:47:73-85. doi: 10.1016/j.bpobgyn.2017.08.012. Epub 2017 Sep 6.


Cervical cancer affects women in their reproductive ages. Screening is an important secondary prevention strategy. The long process of carcinogenic transformation from human papillomavirus (HPV) infection to invasive cancer provides ample opportunities to detect the disease at a stage when treatment is highly effective. Suitable screening tests are cytology, visual inspection after acetic acid application and HPV detection tests. Evidence of effectiveness of the tests to reduce cervical cancer mortality and the cost-effectiveness of screening programs have been demonstrated. Cervical intraepithelial neoplasia grade 2 and grade 3 are the high-grade cervical cancer precursors and need to be treated. Treatment is safe and effective with ablative or excisional techniques. The World Health Organization recommends screening women at least once in a lifetime between 30 and 49 years of age and ensuring effective treatment of the detected abnormalities. Combination of HPV vaccination and population-based screening will be instrumental in eliminating cervical cancer.

Keywords: Ablative treatment; Cervical cancer screening; Excisional treatment; Human papillomavirus detection test; Pap smear cytology; Visual inspection after acetic acid application.

Publication types

  • Review

MeSH terms

  • Disease Progression
  • Early Detection of Cancer*
  • Female
  • Global Burden of Disease
  • Humans
  • Mass Screening / economics
  • Mass Screening / methods*
  • Papanicolaou Test / economics
  • Papanicolaou Test / statistics & numerical data
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis
  • Secondary Prevention*
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Dysplasia / mortality
  • Uterine Cervical Dysplasia / prevention & control*
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaginal Smears / economics
  • Vaginal Smears / statistics & numerical data