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4. Cervical cancer screening:a public health issueJulietta Patnick and Dik Habbema• Organized screening programmes apply to populations, ratherthan individuals• Thousands of women will require follow-up after a positivetest, with further diagnostic procedures, and often treatment,in order to prevent a single case of cervical cancer• Increasing the number of smears offered during a woman’slifetime improves programme sensitivity but diminishes costeffectiveness• Adjustment of any part of the programme can influence theperformance of the whole• <strong>HPV</strong> testing has an exceptionally high negative predictivevalue and may allow some women to be screened lessfrequently