Screening for gynaecological conditions

Well organised cervical screening programmes have reduced the mortality from cervical cancer by up to 50% in the developed world. Despite this, questions remain over: high false negative rates; the role of Human Papillama Virus (HPV) testing; and the management of low grade abnormalities. In contrast, the value of mass screening for ovarian cancer remains unproven, although current screening methods can detect early stage disease in asymptomatic individuals. Breast screening does appear to be associated with a reduction in mortality in the long term but paradoxically may increase death rates in young women in the short term. Testing for sexually transmitted infections is effective in reducing morbidity, but tends to be selective at present because of concerns over the cost and psychosocial implications of general population screening.