A review of cervical cancer and cervical screening: implications for nursing practice.

In this paper we review epidemiological and other research evidence on cervical cancer and cervical screening. We outline recent research evidence implicating sexually transmitted human papillomavirus as one of the causes of cervical cancer, but stress the uncertainty surrounding the causes and natural history of the disease. We go on to discuss evidence on risk factors associated with increased incidence of and mortality from cervical cancer, including age, sexual behaviour, smoking, socioeconomic status and prolonged use of oral contraceptives. Cervical screening has reduced mortality in some countries, and we outline the necessary features of a successful, effective screening programme before going on to describe why screening failed in Britain, at least until the late 1980s. Current screening policy is designed to remedy this, and we discuss its implications, and those of previous research, for nursing practice.