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The foremost approaches include human papillomavirus (HPV) DNA testing and visual [http://en.wikipedia.org/wiki/Resminostat Resminostat] inspection with acetic acid (VIA) as low technology screening tools. Human papillomavirus DNA testing has been shown to be efficacious in screening for precancerous cervical lesions, but its use is limited by the expense. In contrast, VIA is effective and potentially affordable to under-resourced countries. In addition to screening tools, pharmaceutical companies have developed HPV vaccines, which are now widely used in North America and Europe. At present, the costs are prohibitive for under-resourced economies. Ultimately, a combination of complementary approaches will need to be adopted to cut cervical cancer deaths in these countries. This article critically reviews these preferred approaches, HPV and VIA screening, (Figure 1) HPV immunisation (Figure 2) and the topical issues they raise. Sankaranarayanan et al.4 found that HPV DNA testing with referral for colposcopy and treatment produced a 48% reduction in mortality. Its simplicity and reliability make it a promising alternative to cytology-based screening. However, its cost-effectiveness and sustainability profile still need to be carefully considered. Conventional cervical screening programmes using cervical smears or liquid-based cytology are not routinely used in under-resourced countries because they are costly [http://www.selleckchem.com/products/VX-809.html Lumacaftor mw] and technically difficult to implement. In contrast, VIA is a simple screening method: a 4% acetic acid solution is applied to the cervix to reveal precancerous lesions as dense acetowhite areas. A positive screening result is then treated in the same session with either cryotherapy or a loop electrosurgical excision procedure in a ��see and treat�� approach. Visual inspection with acetic acid has been singled out as being the best current alternative to cytology; indeed, studies have validated its efficacy when compared with cytology in India,5 [http://www.selleckchem.com/products/Bafilomycin-A1.html Selleckchem Baf-A1] Africa6 and China.7 One study demonstrated a 25% reduction in cancer incidence and 35% reduction in cancer mortality over 7 years using the ��see and treat�� approach.8 The safety and feasibility of combining VIA and cryotherapy in a single-visit ��see and treat�� approach have been demonstrated in rural Thailand,9 Ghana,10 Guatemala11 and South Africa.12 The main drawback of VIA resides in the operator's tendency to overdiagnose cervical intraepithelial neoplasia (CIN) changes when adequate training and regular monitoring are not in place.13 This can lead to unnecessary treatment and anxiety. Complications of cryotherapy, such as a prolonged watery discharge and mild cramps, occur in