This may explain why significant numbers of patients still die from cervical cancer each year. In the United States, Medicaid recipients and women with no health insurance have the lowest screening rate. Based on this information, it becomes important to develop strategies and provide screening programssss for individuals who are medically underserved. It is also equally important to develop effective education programs to enhance the public awareness of the necessity of utilizing cervical smear screening. Making the pap smear universally available is a major challenge in the fight against cervical cancer.
Controversy remains in regard to the recommended interval of cervical cytologic screening.
Another challenge is the practice of cervically screening. Traditionally, gynecologists have been almost the only physicians involved in the cytologic screening for carcinoma of the cervix. Managed care medicine is now encouraging other primary care physicians or non-physician health care providers to integrate cervical screening in their practice. Potential problems in this strategy include serious concerns about the lack of special expertise in obtaining the sample as well as the diagnosis and management of preinvasive cervical lesions by non-gynecologists. If this trend continues, measures should be taken to assure the familiarity of non-gynecologists with cervical screening procedures.