Cervical cancer should be a historical disease, why are we not succeeding! The prophylactic vaccination will reduce cervical cancer by almost 80% in Belgium. Cervical cancer screening should therefore continue in order to prevent the remaining 20%. The currently used Pap cytology test misses 50% of all clinically significant precancers and cancers at the time of testing. The test should remain but the analysis should be altered. The screening should be modified based on our knowledge of human papillomavirus as a causal factor. Instead of looking for cell abnormality one should look for the presence of human papillomavirus. Then, depending on the test, only two to ten percent of all relevant lesions are missed. The introduction of the vaccination should lead to the reintroduction of the screening based on human papillomavirus. This will lead to a considerable reduction in morbidity and mortality, allow longer screening intervals and be more cost-effective. More for less should be the driving force in cervical cancer screening if we want to be successful.

(BELG J MED ONCOL 2014;8(2):44–51)