Papanicolaou test litigation in the United States reflects widespread societal expectations that even occasional cervical screening should prevent nearly all cervical cancers in screened women. Scientific evidence clearly shows that these expectations are unfounded, especially for increasingly prevalent glandular cervical cancers and for more rapidly progressive cervical cancers in younger women. Reviews of Papanicolaou test slides involved in litigation repeatedly show 1 or more of 3 cytologic patterns: difficult-to-interpret abnormal glandular cell groups, difficult-tointerpret hyperchromatic crowded cell groups, and/or difficult-to-locate or -interpret abnormal immature metaplastic squamous cells. Multipleslide blinded reviews, supported by professional organization guidelines, should be used to identify and differentiate culpable medical errors from factors primarily associated with the inherent limitations of human screening and interpretation. In the authors' opinion, remaining US cases of cervical cancer are most likely to be prevented or minimized by more widespread utilization of cotesting with US Food and Drug AdministrationYapproved methods of liquid-based cytology and high-risk human papillomavirus DNA testing.T he Papanicolaou test is the most successful cancer screening test in medical history. 1 The twin goals of cervical screening are (1) to detect and ablate cervical precancer and (2) to detect and minimize the stage at diagnosis of cases of already invasive cervical cancer. 2 Papanicolaou test litigation consultations provide opportunities for valuable insights into both the natural history of cervical carcinogenesis and the limitations of current cervical screening methods and practices. 3 Although the demonstrated capability of cytology-based screening to detect and prevent or downstage invasive cervical cancer (CxCa) is significantly less for both glandular cervical cancers 4,5 and for more rapidly progressive cervical cancers in younger women, 6 there is, nevertheless, a strong public presumption that almost any cervical screening should essentially guarantee that almost all cervical cancers will be prevented. 3 This presumption that cervical screening should prevent almost all cervical cancers in screened women forms the basis for screened patients' consideration of legal recourse after a cervical cancer diagnosis. In our opinion, the same unfounded presumption that cervical screening should reliably prevent almost all cervical cancers strongly influences most consultants asked by plaintiffs to review durable slide evidence after a diagnosis of CxCa and to ascertain whether a culpable medical error occurred. The multiple-slide blinded rescreening (MSBR) method 3,7Y10 has been developed to improve the objectivity of retrospective reviews of litigated Papanicolaou cases and has had some success in helping to adjudicate and resolve disputed cases. Newer cervical screening technologies also have the potential to help achieve cervical screening performance and outcomes that more closely approach...