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Debates about cervical screening: an historical overview

Correspondence to:
Dr L Bryder, University of Auckland, 5 Wynyard Street, Auckland, New Zealand; l.bryder@auckland.ac.nz

Accepted for publication 23 April 2007

The first 150 words of the full text of this article appear below.

Population-based cervical screening has been promoted widely and enthusiastically as a preventive measure for cervical cancer since the development of the Papanicolaou smear test in the 1940s. In 1984 the Imperial Cancer Research Fund Co-ordinating Committee on Cervical Screening¹ confidently announced "With the exception of stopping the population from smoking, cervical cytological screening offers the only major proved public health measure for significantly reducing the burden of cancer today."

Throughout its history, however, the ‘Pap’ smear has been subject to intense criticism. Critics have wondered whether many lesions or dysplasias identified by smears and treated would have developed into cancer if left alone. From the 1960s, in the light of the growing importance attached to the sciences of biostatistics and epidemiology, others questioned whether screening programmes had reduced the incidence of cervical cancer. Feminists from the 1980s critiqued the interventionist medical model, arguing that the costs to individual women outweighed . . . [Full text of this article]

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