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In fact, one of the most important advances in recent years is the discovery that one of the leading types of cancer in women can be diagnosed in its very earliest stages Thanks to this test known as the Pap smear or the Papanicolaou test the type of cancer that it reveals is about 100 percent curable if detected early enough Progress against Cancer the worlds toughest jigsaw puzzle Advertisement by the Metropolitan Life Insurance Company The National Geographic Magazine Circa 1961 Cancer, a disease of almost unbelievable complexity, has been called the worlds toughest jigsaw puzzle. Fortunately, more and more pieces of the puzzle are falling into place, so that a clearer picture of cancer is emerging optimism for its eventual conquest is increasing

The present study complies with the PRISMA guidelines 190 (Supplementary Tables 9 and 10 and Supplementary Information 1.5) and Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) recommendations 191 (Supplementary Table 11)

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