How to choose and combine cervical cancer screening methods to be most effective?

  Cervical cancer screening is not only the act of physicians, but also the duty of the government, which is a difficult system project. And it is impossible for China to do a standardized screening system like the United States and Australia at present. Regional screening, sentinel screening and opportunistic screening can be done according to local conditions.  All those who visit obstetrics and gynecology clinics and various physical examinations should have cervical cytology examination, and those who have HIV infection, immunosuppression, uterine exposure to hexestrol, receiving cervical intraepithelial neoplasia (CIN II or III) or cervical cancer treatment and other high-risk factors can have more frequent screening.  There are various methods to screen for early cervical cancer, such as traditional cervical cytology smear (Pap smear), liquid-based cytology test (TCT), human papillomavirus (HPV) test, colposcopy, etc. Each has its own advantages, and we don’t need to check each of these items once a year for everyone; a clever combination will make cervical cancer screening more effective.  The combination of HPV typing test and TCT both have extremely high detection sensitivity and can screen out more than 98% of high cervical lesions and cancers, thus minimizing the leakage rate and playing an important role in judging the development trend of cervical lesions, actively dealing with precancerous lesions, interrupting the disease process and preventing the occurrence of cervical cancer.  Judgment of clinical outcomes: For those who are HPV negative and have normal TCT, the risk of development is very low. The follow-up interval can be extended to 3 years.  HPV positive but normal TCT, annual follow-up.  For those who are positive for both HPV and TCT or HPV negative but positive for TCT, colposcopy is feasible and then pathology is purposefully taken to confirm the diagnosis.