The Patient with an Abnormal Pap Smear — Screening Techniques and Management

SQUAMOUS-cell cancer of the cervix originates from intraepithelial precursors whose natural history has been studied extensively and is well understood.¹ There is abundant evidence that these precursors are part of a single disease continuum, called cervical intraepithelial neoplasia, rather than being two separate diseases — dysplasia and carcinoma in situ.² Several screening programs have documented a statistically significant fall in cervical-cancer incidence and death rates that can be attributed to the screening for precursors and to their eradication,³ and Boyes has demonstrated a direct correlation between the intensity of screening and the reduction of cancer in his analysis of cytology . . .