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Cervical screening programs around the world vary significantly, with vast differences in the frequency and age of commencement of screening, if programs exist at all. Within the UK, the NHS cervical screening is currently offered to all women between the ages of 25–64 years on a 3‐year basis until the age of 50 and then every 5 years until 64 years of age. The screening program has recently changed to offer primary HPV screening first, with cytology testing only in those who are high‐risk HPV positive. The aim of all cervical screening programs is to detect precancerous lesions early to avoid the progression to cervical cancer.

Around the world several countries have introduced the HPV vaccination program, with the aim of immunizing girls against the most common oncogenic HPV strains. In the UK this was introduced in 2008 [1] initially with girls alone, and later boys also. The vaccine consists of two injections over 6 months which offer protection against HPV 16 and 18, which are the most common high‐risk oncogenic strains, and 6 and 11 which are associated with genital warts. This offers protection against approximately 70% of the cervical cancers.

Early detection and treatment of cervical abnormalities can prevent 75% of cervical cancers [1]. For those who have normal HPV screening reports the chances of developing cervical cancer in the subsequent 3 to 5 years is low [1]. It is estimated that approximately 4% of those attending for cervical screening will have an abnormality detected. Those reported as low grade should all ideally be seen within the colposcopy service within 6 weeks or as soon as practicable. Those reported as high grade (moderate or severe dyskaryosis, glandular, or possible invasion) should all be seen within 2 weeks [2].

UK practice and the practice in the wider world have changed over the last few years with a drive towards more conservative management, particularly in those who wish to have children. Several studies have evaluated the rates of preterm birth and miscarriage following cervical treatment. It appears those with abnormal cervical screening have a higher rate of preterm birth compared with those with normal cervical screening even without treatment. This could be due to confounding issues such as smoking status and comorbidities although further research in this field is ongoing.

Research suggests 2.5% of all preterm births in the UK are due to cervical treatment with cervical depths of >10mm or more [3].

A 2017 Cochrane review found that those undergoing excisional treatment, whether large loop excision of transformation zone (LLETZ) or cold knife cone, had a higher preterm birth rate than those undergoing ablative treatments. However, these results should be interpreted with caution due to the low quality of the included studies [4].