Young Tae Kim, et al. cases. In conclusion, application of cervicography as primary screening test in conjunction with the Pap test may be slightly helpful as the specificity was increased, the negative predictive value was in- creased, and the false negative rate was decreased. Nevertheless, when consideration is given in terms of its low sensitivity, low positive predictive value and high false positive rate, the clinical application of cervicography with the Pap test as primary screening tests requires further research regarding the cost and effectiveness. REFERENCES 1. Farley J, Parkin DM, Pisani P. GLOBOCAN: Cancer incidence and mortality worldwide, IARC Cancer Base 3. Lyon: International Agency for Research on Cancer; 1998. 2. Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999;80:827-41. 3. Singer A, Jordan JA. The management of premalignant cervical disease. Clin Obstet Gynecol 1978;5:629-37. 4. Coppleson LW, Brown B. Estimation of the screening error rate from the observed detection rates in repeated cervical cytology. Am J Obstet Gynecol 1974;119:953-8. 5. Namgung SE. Diagnosis and management of pre- malignant conditions of the cervix. Korean J Obstet Gynecol 1980;23:89-107. 6. Ferris DG, Payne P, Ferisch LE. Cervicography: an intermediate triage test for the evaluation of cervical atypia. J Fam Pract 1993;37:463-8. 7. Maggi R, Zannoni E, Giorda G. Comparison of re- peated smear, colposcopy and colposcopically directed biopsy in the evaluation of mildly abnormal smear. Gynecol Oncol 1989;35:294-6. 8. Stafl A. Cervicography: A new method for cervical cancer detection. Am J Obstet Gynecol 1981;139:815-25. 9. Hocutt JE, Clark RR, Pfenninger JL. Papanicolaou testing and colposcopic screening. J Fam Pract 1992;34: 38-40. 10. Burke L. Cervicography: An alternative modality of cervical screening. Diag Cytopathol 1990;6:1-2. 11. Kim SC, Kim CJ, Kim JH. New Cervicography: the usefulness as a primary screening test of the cervical Yonsei Med J Vol. 46, No. 2, 2005 cancer. Korean J Cancer 1997;1:108-17. 12. Sankaranarayanan R, Black R, Parkin DM. Cancer survival in developing countries, LARC Scientific Publications No.145. Lyon: International Agency for Research on Cancer; 1998a. 13. IARC working group on evaluation of cervical cancer screening programs. Screening for squamous cervical cancer; duration of low risk after negative cytology and its implication for screening policies. Br Med J 1987;293: 659-64. 14. Laura E, Day NE, Hakama M. Trends in mortality from cervical cancer in the Nordic countries; association with organized screening programs. Lancet 1987;30:1247-9. 15. Soost HJ, Lange HJ, Lehmacher W, Ruffing-Kullmann B. The validation of cervical cytology-sensitivity, speci- ficity and predictive value. Acta Cytol 1991;35:8-14. 16. Richart RM. Evaluation of the true false negative in cytology. Am J Obstet Gynecol 1964;89:723-31. 17. Sherman ME, Mango LJ, Kelly D. PAPNET Analysis of reportedly negative smears preceding the diagnosis of a high-grade squamous intraepithelial lesion or carci- noma. Med Pathol 1994;9:411-5. 18. Orr WJ Jr, Shingleton HM. Screening in cancer of the cervix. Philadelphia: JB Lippincott Company; 1995. 19. Giles JA, Hudson E, Crow J, et al. Colposcopic assess- ment of the accuracy of cervical cytology screening. Br Med J 1988;296:1099-102. 20. Han SK, Ahn WS, Lee JM. Correlation of cytology, colposcopy and cervicography in the diagnosis of early cervical neoplasia. Korean J Obstet Gynecol 1988;31: 1738-46. 21. Favaheirier G, Fejgin MD. Diagnostic value of colpos- copy in the investigation of cervical neoplasia. Am J Obstet Gynecol 1980;137:588-96. 22. Stafl, A. Cervicography: a new approach to cervical cancer detection, presented at the conference on early cervical neoplasia. Gynecol Oncol 1981;12:292-301. 23. Szarewski A, Cuzick J, Edwards R. The use of cervi- cography in the primary screening service. Br J Obstet Gynecol 1991;98:313-17. 24. Campion MJ, Reid R. Screening for gynecologic cancer. Obstet Gynecol Clin North Am 1990;17:695-727. 25. Kang SE, Kim YT, Kim JW. Can cervicography play a supportive role in the screening of uterine cervical cancer? Korean J Gynecol Oncol Colpo 1998;9:115-22. 26. Ahn TG, Kim TJ, Han SJ. The clinical usefulness of the combined tests (Papanicolau smear + cervicography) for screening of cervical cancer. Korean J Gynecol Oncol Colpo 2001;12:210-6.