Cervical screening: ESGO-EFC position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation of Colposcopy (EFC)


This paper summarises the position of ESGO and EFC on cervical screening based on existing guidelines and opinions of a team of lead experts. HPV test is replacing cytology as this offers greater protection against cervical cancer and allows longer screening intervals. Only a dozen of HPV tests are considered as clinically validated for screening. The lower specificity of HPV test dictates the use of triage tests that can select women for colposcopy. Reflex cytology is currently the only well validated triage test; HPV genotyping and p16 immunostaining may be used in the future, although methylation assays and viral load also look promising. A summary of quality assurance benchmarks is provided, and the importance to audit the screening histories of women who developed cancer is noted as a key objective. HPV-based screening is more cost-effective than cytology or cotesting. HPV-based screening should continue in the post-vaccination era. Only a fraction of the female population is vaccinated, and this varies across countries. A major challenge will be to personalise screening frequency according to vaccination status. Still the most important factor for successful prevention by screening is high population coverage and organised screening. Screening with self-sampling to reach under-screened women is promising.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1.

    Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M. et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer 136, E359–E386 (2015).

    CAS  PubMed  Google Scholar 

  2. 2.

    IARC. Cervix cancer screening, Vol 10 (IARC, Lyon, 2005).

  3. 3.

    CancerResearchUK. Cervical cancer incidence statistics. https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/cervical-cancer/incidence. (2015).

  4. 4.

    Anttila, A. & Nieminen, P. Cervical cancer screening programme in Finland with an example on implementing alternative screening methods. Coll. Antropol. 31(Suppl 2), 17–22 (2007).

    PubMed  Google Scholar 

  5. 5.

    NICE. Guidance on the use of liquid-based cytology for cervical screening. http://www.nice.org.uk (2003).

  6. 6.

    Arbyn, M., Bergeron, C., Klinkhamer, P., Martin-Hirsch, P., Siebers, A. G. & Bulten, J. Liquid compared with conventional cervical cytology: a systematic review and meta-analysis. Obstet. Gynecol. 111, 167–177 (2008).

    PubMed  Google Scholar 

  7. 7.

    Insinga, R. P., Glass, A. G. & Rush, B. B. Diagnoses and outcomes in cervical cancer screening: a population-based study. Am. J. Obstet. Gynecol. 191, 105–113 (2004).

    PubMed  Google Scholar 

  8. 8.

    Arbyn, M., Anttila, A., Jordan, J., Ronco, G., Schenck, U., Segnan, N. et al. European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition-summary document. Ann. Oncol. 21, 448–458 (2010).

    CAS  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Ronco, G., Dillner, J., Elfstrom, K. M., Tunesi, S., Snijders, P. J., Arbyn, M. et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet 383, 524–532 (2014).

    PubMed  Google Scholar 

  10. 10.

    Koliopoulos, G., Arbyn, M., Martin-Hirsch, P., Kyrgiou, M., Prendiville, W., Paraskevaidis, E. Diagnostic accuracy of human papillomavirus testing in primary cervical screening: a systematic review and meta-analysis of non-randomized studies. Gynecol Oncol. 104, 232–246 (2007).

    PubMed  Google Scholar 

  11. 11.

    Torres, K. L., Marino, J. M., Pires Rocha, D. A., de Mello, M. B., de Melo Farah, H. H., Reis, R., D. S et al. Self-sampling coupled to the detection of HPV 16 and 18 E6 protein: A promising option for detection of cervical malignancies in remote areas. PLoS ONE 13, e0201262 (2018).

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Cuzick, J., Clavel, C., Petry, K. U., Meijer, C. J., Hoyer, H., Ratnam, S. et al. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int. J. Cancer 119, 1095–1101 (2006).

    CAS  PubMed  Google Scholar 

  13. 13.

    Arbyn, M., Ronco, G., Anttila, A., Meijer, C. J., Poljak, M., Ogilvie, G. et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine 30, F88–F99 (2012).

    PubMed  Google Scholar 

  14. 14.

    Ogilvie, G. S., van Niekerk, D., Krajden, M., Smith, L. W., Cook, D., Gondara, L. et al. Effect of screening with primary cervical HPV testing vs cytology testing on high-grade cervical intraepithelial neoplasia at 48 months: the HPV FOCAL Randomized Clinical Trial. JAMA 320, 43–52 (2018).

    PubMed  PubMed Central  Google Scholar 

  15. 15.

    Sankaranarayanan, R., Nene, B. M., Shastri, S. S., Jayant, K., Muwonge, R., Budukh, A. M. et al. HPV screening for cervical cancer in rural India. N. Engl. J. Med. 360, 1385–1394 (2009).

    CAS  PubMed  Google Scholar 

  16. 16.

    O’Connor, M., O’Leary, E., Waller, J., Gallagher, P., Martin, C. M., O’Leary, J. J. et al. Socio-economic variations in anticipated adverse reactions to testing HPV positive: implications for the introduction of primary HPV-based cervical screening. Preventive Med. 115, 90–96 (2018).

    Google Scholar 

  17. 17.

    Arbyn, M., Verdoodt, F., Snijders, P. J., Verhoef, V. M., Suonio, E., Dillner, L. et al. Accuracy of human papillomavirus testing on self-collected versus clinician-collected samples: a meta-analysis. Lancet Oncol. 15, 172–183 (2014).

    PubMed  Google Scholar 

  18. 18.

    Arbyn, M., Smith, S. B., Temin, S., Sultana, F. & Castle, P. Detecting cervical precancer and reaching underscreened women by using HPV testing on self samples: updated meta-analyses. BMJ 363, k4823 (2018).

    PubMed  PubMed Central  Google Scholar 

  19. 19.

    von Karsa, L., Arbyn, M., De Vuyst, H., Dillner, J., Dillner, L., Franceschi, S. et al. European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination. Papillomavirus Res. 1, 22–31 (2015).

    Google Scholar 

  20. 20.

    Poljak, M. & Kocjan, B. J. Commercially available assays for multiplex detection of alpha human papillomaviruses. Expert Rev. Anti Infect. Ther. 8, 1139–1162 (2010).

    CAS  PubMed  Google Scholar 

  21. 21.

    Poljak, M., Cuzick, J., Kocjan, B. J., Iftner, T., Dillner, J. & Arbyn, M. Nucleic acid tests for the detection of alpha human papillomaviruses. Vaccine 30(Suppl 5), F100–F106 (2012).

    CAS  PubMed  Google Scholar 

  22. 22.

    Poljak, M., Kocjan, B. J., Ostrbenk, A. & Seme, K. Commercially available molecular tests for human papillomaviruses (HPV): 2015 update. J. Clin. Virol. 76(Suppl 1), S3–s13 (2016).

    CAS  PubMed  Google Scholar 

  23. 23.

    Arbyn, M., Snijders, P. J., Meijer, C. J., Berkhof, J., Cuschieri, K., Kocjan, B. J. et al. Which high-risk HPV assays fulfil criteria for use in primary cervical cancer screening? Clin. Microbiol. Infect. 21, 817–826 (2015).

    CAS  PubMed  Google Scholar 

  24. 24.

    Meijer, C. J., Berkhof, J., Castle, P. E., Hesselink, A. T., Franco, E. L., Ronco, G. et al. Guidelines for human papillomavirus DNA test requirements for primary cervical cancer screening in women 30 years and older. Int. J. Cancer 124, 516–520 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  25. 25.

    Ronco, G., Arbyn, M., Meijer, C. J. L. M., Snijders, P. J. F., Cuzick, J. Screening for Cervical Cancer with Primary Testing for Human Papillomavirus (Supplement 1), 2nd edn (Office for Official Publications of the European Union, Luxembourg, 2015).

  26. 26.

    Wheeler, C. M., Hunt, W. C., Cuzick, J., Langsfeld, E., Pearse, A., Montoya, G. D. et al. A population-based study of human papillomavirus genotype prevalence in the United States: baseline measures prior to mass human papillomavirus vaccination. Int. J. Cancer 132, 198–207 (2013).

    CAS  PubMed  Google Scholar 

  27. 27.

    Cuzick, J. & Wheeler, C. Need for expanded HPV genotyping for cervical screening. Papillomavirus Res. 2, 112–115 (2016).

    PubMed  PubMed Central  Google Scholar 

  28. 28.

    Aro, K., Nieminen, P., Louvanto, K., Jakobsson, M., Virtanen, S., Lehtinen, M. et al. Age-specific HPV type distribution in high-grade cervical disease in screened and unvaccinated women. Gynecol. Oncol. 154, 354–359 (2019).

    PubMed  Google Scholar 

  29. 29.

    Massad, L. S., Einstein, M. H., Huh, W. K., Katki, H. A., Kinney, W. K., Schiffman, M. et al. 2012 updated consensus guidelines for the management of abnormal cervical cancer screening tests and cancer precursors. J. Low. Genit. Trac. Dis. 17, S1–s27 (2013).

    Google Scholar 

  30. 30.

    Rebolj, M., Rimmer, J., Denton, K., Tidy, J., Mathews, C., Ellis, K. et al. Primary cervical screening with high risk human papillomavirus testing: observational study. BMJ 364, l240 (2019).

    PubMed  PubMed Central  Google Scholar 

  31. 31.

    Tsoumpou, I., Arbyn, M., Kyrgiou, M., Wentzensen, N., Koliopoulos, G., Martin-Hirsch, P. et al. p16(INK4a) immunostaining in cytological and histological specimens from the uterine cervix: a systematic review and meta-analysis. Cancer Treat Rev. 35, 210–220 (2009).

    CAS  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Tsoumpou, I., Valasoulis, G., Founta, C., Kyrgiou, M., Nasioutziki, M., Daponte, A. et al. High-risk human papillomavirus DNA test and p16(INK4a) in the triage of LSIL: a prospective diagnostic study. Gynecol Oncol. 121, 49–53 (2011).

    CAS  PubMed  Google Scholar 

  33. 33.

    Ronco, G., Giorgi-Rossi, P., Carozzi, F., Confortini, M., Dalla Palma, P., Del Mistro, A. et al. Results at recruitment from a randomized controlled trial comparing human papillomavirus testing alone with conventional cytology as the primary cervical cancer screening test. J. Natl Cancer Inst. 100, 492–501 (2008).

    PubMed  Google Scholar 

  34. 34.

    Wright, T. C. Jr, Behrens, C. M., Ranger-Moore, J., Rehm, S., Sharma, A., Stoler, M. H. et al. Triaging HPV-positive women with p16/Ki-67 dual-stained cytology: results from a sub-study nested into the ATHENA trial. Gynecol. Oncol. 144, 51–56 (2017).

    PubMed  Google Scholar 

  35. 35.

    Ikenberg, H., Bergeron, C., Schmidt, D., Griesser, H., Alameda, F., Angeloni, C. et al. Screening for cervical cancer precursors with p16/Ki-67 dual-stained cytology: results of the PALMS study. J. Natl Cancer Inst. 105, 1550–1557 (2013).

    CAS  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Luttmer, R., De Strooper, L. M., Berkhof, J., Snijders, P. J., Dijkstra, M. G., Uijterwaal, M. H. et al. Comparing the performance of FAM19A4 methylation analysis, cytology and HPV16/18 genotyping for the detection of cervical (pre)cancer in high-risk HPV-positive women of a gynecologic outpatient population (COMETH study). Int. J. Cancer 138, 992–1002 (2016).

    CAS  PubMed  Google Scholar 

  37. 37.

    Lorincz, A. T., Brentnall, A. R., Vasiljevic, N., Scibior-Bentkowska, D., Castanon, A., Fiander, A. et al. HPV16 L1 and L2 DNA methylation predicts high-grade cervical intraepithelial neoplasia in women with mildly abnormal cervical cytology. Int. J. Cancer 133, 637–644 (2013).

    CAS  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Louvanto, K., Aro, K., Nedjai, B., Butzow, R., Jakobsson, M., Kalliala, I., et al. Methylation in predicting progression of untreated high-grade cervical intraepithelial neoplasia. Clin. Infect. Dis. pii: ciz677. (2019).

  39. 39.

    Gravitt, P. E., Kovacic, M. B., Herrero, R., Schiffman, M., Bratti, C., Hildesheim, A. et al. High load for most high risk human papillomavirus genotypes is associated with prevalent cervical cancer precursors but only HPV16 load predicts the development of incident disease. Int. J. Cancer 121, 2787–2793 (2007).

    CAS  PubMed  PubMed Central  Google Scholar 

  40. 40.

    Xi, L. F., Hughes, J. P., Castle, P. E., Edelstein, Z. R., Wang, C., Galloway, D. A. et al. Viral load in the natural history of human papillomavirus type 16 infection: a nested case-control study. J. Infect. Dis. 203, 1425–1433 (2011).

    PubMed  PubMed Central  Google Scholar 

  41. 41.

    Fu, Xi,L., Schiffman, M., Ke, Y., Hughes, J. P., Galloway, D. A., He, Z. et al. Type-dependent association between risk of cervical intraepithelial neoplasia and viral load of oncogenic human papillomavirus types other than types 16 and 18. Int. J. Cancer 140, 1747–1756 (2017).

    Google Scholar 

  42. 42.

    Vasiljevic, N., Carter, P. D., Reuter, C., Warman, R., Brentnall, A. R., Carton, J. R. et al. Role of quantitative p16(INK4A) mRNA assay and digital reading of p16(INK4A) immunostained sections in diagnosis of cervical intraepithelial neoplasia. Int. J. Cancer 141, 829–836 (2017).

    CAS  PubMed  PubMed Central  Google Scholar 

  43. 43.

    Coleman, D., Day, N., Douglas, G., Farmery, E., Lynge, E., Philip, J. et al. European Guidelines for Quality Assurance in Cervical Cancer Screening. Europe against cancer programme. Eur. J. Cancer 29A(Suppl 4), S1–S38 (1993).

    PubMed  Google Scholar 

  44. 44.

    Mendes, D., Bains, I., Vanni, T. & Jit, M. Systematic review of model-based cervical screening evaluations. BMC Cancer 15, 334 (2015).

    PubMed  PubMed Central  Google Scholar 

  45. 45.

    Goldhaber-Fiebert, J. D., Stout, N. K., Salomon, J. A., Kuntz, K. M. & Goldie, S. J. Cost-effectiveness of cervical cancer screening with human papillomavirus DNA testing and HPV-16,18 vaccination. J. Natl Cancer Inst. 100, 308–320 (2008).

    PubMed  PubMed Central  Google Scholar 

  46. 46.

    Huh, W. K., Williams, E., Huang, J., Bramley, T. & Poulios, N. Cost effectiveness of human papillomavirus-16/18 genotyping in cervical cancer screening. Appl. Health Econ. Health Policy 13, 95–107 (2015).

    PubMed  Google Scholar 

  47. 47.

    Kim, J. J., Burger, E. A., Sy, S., Campos, N. G. Optimal cervical cancer screening in women vaccinated against human papillomavirus. J. Natl Cancer Inst. 109, djw216 (2016).

    PubMed  PubMed Central  Google Scholar 

  48. 48.

    Lew, J. B., Simms, K. T., Smith, M. A., Hall, M., Kang, Y. J., Xu, X. M. et al. Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: effectiveness and economic assessment for the National Cervical Screening Program. Lancet Public Health 2, e96–e107 (2017).

    PubMed  Google Scholar 

  49. 49.

    de Kok, I. M., van Rosmalen, J., Dillner, J., Arbyn, M., Sasieni, P., Iftner, T. et al. Primary screening for human papillomavirus compared with cytology screening for cervical cancer in European settings: cost effectiveness analysis based on a Dutch microsimulation model. BMJ 344, e670 (2012).

    PubMed  PubMed Central  Google Scholar 

  50. 50.

    de Kok, I., Korfage, I. J., van den Hout, W. B., Helmerhorst, T. J. M., Habbema, J. D. F., Essink-Bot, M. L. et al. Quality of life assumptions determine which cervical cancer screening strategies are cost-effective. Int. J. Cancer 142, 2383–2393 (2018).

    PubMed  Google Scholar 

  51. 51.

    Palmer, T., Wallace, L., Pollock, K. G., Cuschieri, K., Robertson, C., Kavanagh, K. et al. Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study. BMJ 365, l1161 (2019).

    PubMed  PubMed Central  Google Scholar 

  52. 52.

    Mesher, D., Panwar, K., Thomas, S. L., Edmundson, C., Choi, Y. H., Beddows, S. et al. The impact of the National HPV Vaccination Program in England using the bivalent HPV vaccine: surveillance of type-specific HPV in young females, 2010–2016. J. Infect. Dis. 218, 911–921 (2018).

    PubMed  Google Scholar 

  53. 53.

    Ferris, D. G., Samakoses, R., Block, S. L., Lazcano-Ponce, E., Restrepo, J. A., Mehlsen, J., et al. 4-valent human papillomavirus (4vHPV) vaccine in preadolescents and adolescents after 10 years. Pediatrics 140, e20163947 (2017).

    PubMed  Google Scholar 

  54. 54.

    Schwarz, T. F., Galaj, A., Spaczynski, M., Wysocki, J., Kaufmann, A. M., Poncelet, S. et al. Ten-year immune persistence and safety of the HPV-16/18 AS04-adjuvanted vaccine in females vaccinated at 15–55 years of age. Cancer Med. 6, 2723–2731 (2017).

    CAS  PubMed  PubMed Central  Google Scholar 

  55. 55.

    Pedersen, K., Burger, E. A., Nygård, M., Kristiansen, I. S. & Kim, J. J. Adapting cervical cancer screening for women vaccinated against human papillomavirus infections: the value of stratifying guidelines. Eur. J. Cancer 91, 68–75 (2018).

    PubMed  PubMed Central  Google Scholar 

  56. 56.

    Giorgi Rossi, P., Carozzi, F., Federici, A., Ronco, G., Zappa, M. & Franceschi, S. Cervical cancer screening in women vaccinated against human papillomavirus infection: recommendations from a consensus conference. Prev. Med. 98, 21–30 (2017).

    PubMed  Google Scholar 

  57. 57.

    Landy, R., Windridge, P., Gillman, M. S. & Sasieni, P. D. What cervical screening is appropriate for women who have been vaccinated against high risk HPV? A simulation study. Int. J. Cancer 142, 709–718 (2018).

    CAS  PubMed  Google Scholar 

  58. 58.

    Pollock, K. G., Kavanagh, K., Potts, A., Love, J., Cuschieri, K., Cubie, H. et al. Reduction of low- and high-grade cervical abnormalities associated with high uptake of the HPV bivalent vaccine in Scotland. Br. J. Cancer 111, 1824–1830 (2014).

    CAS  PubMed  PubMed Central  Google Scholar 

  59. 59.

    Guan, P., Howell-Jones, R., Li, N., Bruni, L., de Sanjosé, S., Franceschi, S. et al. Human papillomavirus types in 115,789 HPV-positive women: A meta-analysis from cervical infection to cancer. Int. J. Cancer 131, 2349–2359 (2012).

    CAS  PubMed  Google Scholar 

  60. 60.

    Franco, E. L., Mahmud, S. M., Tota, J., Ferenczy, A. & Coutlee, F. The expected impact of HPV vaccination on the accuracy of cervical cancer screening: the need for a paradigm change. Arch. Med. Res. 40, 478–485 (2009).

    PubMed  Google Scholar 

  61. 61.

    Castle, P. E., Stoler, M. H., Wright, T. C. Jr., Sharma, A., Wright, T. L. & Behrens, C. M. Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol. 12, 880–890 (2011).

    PubMed  Google Scholar 

  62. 62.

    HealthCouncil. Screening for cervical cancer [Screening op baarmoederhalskanker], Vol 2011/07 (Health Council, Den Haag, 2011).

  63. 63.

    Kitchener, H. C., Canfell, K., Gilham, C., Sargent, A., Roberts, C., Desai, M. et al. The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England: extended follow-up of the ARTISTIC randomised trial cohort through three screening rounds. Health Technol. Assess. 18, 1–196 (2014).

    Google Scholar 

  64. 64.

    Bains, I., Choi, Y. H., Soldan, K., Jit, M. Clinical impact and cost-effectiveness of primary cytology versus human papillomavirus testing for cervical cancer screening in England. Int. J. Gynecol. Cancer ijgc-2018-000161 (2019).

  65. 65.

    Gultekin, M., Zayifoglu Karaca, M., Kucukyildiz, I., Dundar, S., Boztas, G., Semra Turan, H. et al. Initial results of population based cervical cancer screening program using HPV testing in one million Turkish women. Int. J. Cancer 142, 1952–1958 (2018).

    CAS  PubMed  Google Scholar 

  66. 66.

    Ronco, G., Biggeri, A., Confortini, M., Naldoni, C., Segnan, N., Sideri, M. et al. [Health technology assessment report: HPV DNA based primary screening for cervical cancer precursors]. Epidemiol. Prev. 36, e1–e72 (2012).

    PubMed  Google Scholar 

  67. 67.

    Ronco, G., Giorgi Rossi, P., Giubilato, P., Del Mistro, A., Zappa, M. & Carozzi, F. A first survey of HPV-based screening in routine cervical cancer screening in Italy. Epidemiol. Prev. 39, 77–83 (2015).

    PubMed  Google Scholar 

  68. 68.

    Ronco, G., Zappa, M., Franceschi, S., Tunesi, S., Caprioglio, A., Confortini, M. et al. Impact of variations in triage cytology interpretation on human papillomavirus-based cervical screening and implications for screening algorithms. Eur. J. Cancer 68, 148–155 (2016).

    PubMed  Google Scholar 

Download references


European Society of Gynaecologic Oncology (ESGO) and the European Federation of Colposcopy (EFC).

Author information




M.K. edited and contributed to the content of all chapters. The paper was conceived by M.G. and J.C. More specifically: Cytology (P.S., C.B.); HPV test (K.C., M.P., C.B.); Quality assurance (J.D., V.K., M.A.); cost-effectiveness (M.J., J.K.); screening in vaccinated (X.B., P.S.). All authors have contributed to the writing of the manuscript and have approved the final version.

Corresponding author

Correspondence to Maria Kyrgiou.

Ethics declarations

Ethics approval and consent to participate

not applicable.

Consent to publish

All authors have given consent to publish.

Data availability

Data sharing is not applicable to this article as no datasets were generated or analysed during the current study.

Competing interests

F.X.B. has received institutional research and educational support from Hologic and MSD and personal support from MSD, Hologic and Seegen for traveling and speaking at medical symposiums; M.G. has received personal support from MSD for traveling and speaking at medical symposiums; M.K. has received institutional research and educational support from MSD and personal support from MSD and Hologic for traveling and speaking at medical symposiums. The rest report no conflict of interest. MA’s institution received funding from the European Society of Gynaecological Oncology, the European Federation for Colposcopy and the Horizon 2020 Framework Programme for Research and Innovation of the European Commission, through the RISCC Network (grant no. 847845). J.C. is an editorial board member of the BJC.

Funding information

There was no funding.

Additional information

Note This work is published under the standard license to publish agreement. After 12 months the work will become freely available and the license terms will switch to a Creative Commons Attribution 4.0 International (CC BY 4.0).

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kyrgiou, M., Arbyn, M., Bergeron, C. et al. Cervical screening: ESGO-EFC position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation of Colposcopy (EFC). Br J Cancer 123, 510–517 (2020). https://doi.org/10.1038/s41416-020-0920-9

Download citation

Further reading


Quick links