Cancer screening of the uterine cervix papanicolaou smears versus state-of-the-art human papillomavirus testing†‡

The article by Albrow et al in this issue describes the early cervical screening program in England as being “disorganized,” but goes on to describe significant improvements over 20 years. It has become one of the leading screening programs in the developed world. Liquid-based technology has been embraced, but image analysis has not. The key ingredient for the NHSCSP's success is quality assurance. The scrutiny given to medical interventions has increased recently. Would the early cervical cancer cytology screening programs have passed muster if they had required this sort of validation? Using information from the Victorian Cytology Screening Services Melbourne and other Australian screening programs to guide its formulation, Australia's evidence-based program differs from the NHSCSP in several ways. The screening interval is 2 years, liquid-based technology is not funded, and human papillomavirus (HPV)-DNA testing for the triage of atypical lesions has not been sanctioned in Australia. Albrow et al allude to the possible introduction in the future of HPV-DNA testing as a primary screening tool. Cancer (Cancer Cytopathol) 2012;. © 2012 American Cancer Society.