Deep Learning for Cervical Cytology Screening: Methods, Algorithms, Challenges and Prospects
Jiang Yangbo, Zheng Nenggan
Cervical cancer remains a leading cause of cancer death among women, with more than 90\% of deaths occurring in low- and middle-income countries, where cytology screening is constrained by a shortage of trained cytopathologists. Deep learning has made automated cytology screening increasingly feasible, but the literature is fragmented across cell, patch and whole-slide-image scales, task formulations and supervision regimes, hindering comparison and clinical translation. This Review synthesizes the deep learning literature for cervical cytology screening, organizing the field along three axes---data scale, functional task and supervision---and distinguishing two clinical roadmaps: whole-slide-image confidence aggregation and cell-level detection with Bethesda classification. We examine 16 publicly available or publicly documented cytology datasets alongside the CAISHI histopathology dataset, compare quantitative performance while exposing incomparable metrics and data leakage, and assess commercial systems, regulatory status, HPV-era screening pathways and low-resource deployment. Single-cell accuracy on Herlev and SIPaKMeD has plateaued, but this reflects benchmark saturation rather than clinical readiness; prospective and randomized evidence is emerging but remains limited. We consolidate the evidence into five challenge areas---data and benchmarks, architecture and label-efficient learning, trustworthy AI, clinical translation and health economics, and evaluation and reproducibility---and provide an evidence-to-agenda map and a deployment decision matrix. Progress now depends on multi-center benchmarks, externally validated label-efficient methods, calibrated and fair predictions, and pragmatic clinical trials rather than further gains on saturated single-cell benchmarks.
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