Contemporary Status and Frontiers of Cervical Cancer Screening in the United States

Cervical cancer screening and its implementation have evolved tremendously since the first method, cytology using the Papanicolaou stain, was introduced in the 1950s. New screening methods, such as human papillomavirus testing, have been discovered, and evidence-based changes have been made to official screening guidelines set forth by various US organizations. With the advent of a human papillomavirus vaccine in 2006 and with more recent research into populations carrying disparate burdens of cervical disease, the effectiveness of current cervical cancer screening programs is being called into question as the disease incidence has not decreased as expected in the past 20 years. This review highlights where cervical cancer screening in the United States started, the current clinical methods, and promising developments on the frontiers of screening research to introduce new screening options or improve current screening programs and outcomes. We also highlight certain population factors that hinder effective screening in high-risk groups, based on research aimed at ensuring that population-wide screening continues to be an effective strategy for reducing cervical cancer incidence and mortality.