K Decker1,2, N Baines3, C Muzyka4, M Lee5, M H Mayrand6, H Yang7, S Fung3, D Mercer8, S McFaul9, R Kupets10, R Savoie11, R Lotocki12, J Bentley13. 1. Department of Community Health Sciences, University of Manitoba, Winnipeg, MB. 2. Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB. 3. Canadian Partnership Against Cancer, Toronto, ON. 4. Department of Epidemiology, CancerCare Manitoba, Winnipeg, MB. 5. BC Cancer, Vancouver, BC. 6. Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Université de Montréal, Montreal, QC. 7. Population, Public and Aboriginal Health, Alberta Health Services, Calgary, AB. 8. Cervical Screening Initiatives Program, Eastern Health, St. John's, NL. 9. Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON. 10. Ontario Cervical Screening Program, Cancer Care Ontario, Toronto, ON. 11. New Brunswick Department of Health, Fredericton, NB. 12. CervixCheck Manitoba, CancerCare Manitoba, Winnipeg, MB. 13. Department of Obstetrics and Gynaecology, Dalhousie University, Halifax, NS.
Abstract
Background: Colposcopy is a key part of cervical cancer control. As cervical cancer screening and prevention strategies evolve, monitoring colposcopy performance will become even more critical. In the present paper, we describe population-based colposcopy quality indicators that are recommended for ongoing measurement by cervical cancer screening programs in Canada. Methods: The Pan-Canadian Cervical Cancer Screening Network established a multidisciplinary expert working group to identify population-based colposcopy quality indicators. A systematic literature review was conducted to ascertain existing population and program-level colposcopy quality indicators. A systems-level cervical cancer screening pathway describing each step from an abnormal screening test, to colposcopy, and back to screening was developed. Indicators from the literature were assigned a place on the pathway to ensure that all steps were measured. A prioritization matrix scoring system was used to score each indicator based on predetermined criteria. Proposed colposcopy quality indicators were shared with provincial and territorial screening programs and subsequently revised. Results: The 10 population-based colposcopy quality indicators identified as priorities were colposcopy uptake, histologic investigation (biopsy) rate, colposcopy referral rate, failure to attend colposcopy, treatment frequency in women 18-24 years of age, re-treatment proportion, colposcopy exit-test proportion, histologic investigation (biopsy) frequency after low-grade Pap test results, length of colposcopy episode of care, and operating room treatment rate. Two descriptive indicators were also identified: colposcopist volume and number of colposcopists per capita. Summary: High-quality colposcopy services are an essential component of provincial cervical cancer screening programs. The proposed quality and descriptive indicators will permit colposcopy outcomes to be compared between provinces and across Canada so as to identify opportunities for improving colposcopy services.
Background: Colposcopy is a key part of cervical cancer control. As cervical cancer screening and prevention strategies evolve, monitoring colposcopy performance will become even more critical. In the present paper, we describe population-based colposcopy quality indicators that are recommended for ongoing measurement by cervical cancer screening programs in Canada. Methods: The Pan-Canadian Cervical Cancer Screening Network established a multidisciplinary expert working group to identify population-based colposcopy quality indicators. A systematic literature review was conducted to ascertain existing population and program-level colposcopy quality indicators. A systems-level cervical cancer screening pathway describing each step from an abnormal screening test, to colposcopy, and back to screening was developed. Indicators from the literature were assigned a place on the pathway to ensure that all steps were measured. A prioritization matrix scoring system was used to score each indicator based on predetermined criteria. Proposed colposcopy quality indicators were shared with provincial and territorial screening programs and subsequently revised. Results: The 10 population-based colposcopy quality indicators identified as priorities were colposcopy uptake, histologic investigation (biopsy) rate, colposcopy referral rate, failure to attend colposcopy, treatment frequency in women 18-24 years of age, re-treatment proportion, colposcopy exit-test proportion, histologic investigation (biopsy) frequency after low-grade Pap test results, length of colposcopy episode of care, and operating room treatment rate. Two descriptive indicators were also identified: colposcopist volume and number of colposcopists per capita. Summary: High-quality colposcopy services are an essential component of provincial cervical cancer screening programs. The proposed quality and descriptive indicators will permit colposcopy outcomes to be compared between provinces and across Canada so as to identify opportunities for improving colposcopy services.
Entities:
Keywords:
Colposcopy; mass screening; quality of health care
Authors: M E Cruickshank; J Pan; S C Cotton; K Kavanagh; C Robertson; K Cuschieri; H Cubie; T Palmer; K G Pollock Journal: BJOG Date: 2017-03-09 Impact factor: 6.531