scholarly journals Measuring colposcopy quality in Canada: development of population-based indicators

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
K. Decker ◽  
N. Baines ◽  
C. Muzyka ◽  
M. Lee ◽  
M. H. Mayrand ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Quality Indicators ◽  
Pap Test ◽  
Population Based ◽  
Low Grade ◽  
Treatment Rate ◽  
Treatment Frequency ◽  
Screening Programs

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.

scholarly journals Methodologies of Primary HPV Testing Currently Applied for Cervical Cancer Screening

Life ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 290
Author(s):  
Andreas C. Chrysostomou ◽  
Leondios G. Kostrikis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
Population Based ◽  
World Health ◽  
Hpv Testing ◽  
Screening Programs ◽  
European Guidelines ◽  
Health Organization

The human papillomavirus is one of the most common sexually transmitted viruses, and an infection from this virus may become persistent, leading to diseases such as cervical cancer. In the past, cytology-based methods such as the Papanicolaou (Pap) test were imperative to identify the disease at a stage where it can be treated. However, since the 1980s where the etiological association of HPV and cervical cancer was identified, new tests began emerging directed towards identifying the virus. Furthermore, as the biology of HPV along with the relationships with its host are elucidated, these tests and treatments further advance. Recently in Europe, there is a movement towards the implementation of HPV testing methodologies in national screening programs to precede cytological testing. These screening strategies are recommended by the European guidelines and the World Health Organization. This review presents the current HPV testing methodologies, their application in organized population-based cervical cancer screening programs based on the most recent European guidelines, and their implementation status in countries in Europe.

scholarly journals Automated Quantitative Cytology Imaging Analysis System in Cervical Cancer Screening in Shanxi Province, China

2017 ◽  
Vol 6 (2) ◽  
pp. 51 ◽  
Author(s):  
Yan Dong ◽  
Jigeng Bai ◽  
Yuping Zhang ◽  
Guangjie Shang ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Shanxi Province ◽  
Detection Rates ◽  
Screening Programs ◽  
Quantitative Cytology ◽  
Automated Platform

Purpose: In China the number of pathologists is far from being enough to meet the demands of ongoing population based cervical cancer screening programs. This article aims to present our experience with automated quantitative cytology imaging platform, a reading system with an artificial intelligence that we currently use routinely for cervical cancer screening in Shanxi province.Methods: From 2012-2016 a total of 40 178 women were screened. Women were divided into three groups and each group had two subgroups. Smear and liquid based technique were compared using manual and automated platform.Results: Detection rates of CIN2 + and positive rates of CIN2 were higher in all three groups when automated quantitative cytology platform was used compared with groups where reading was done by the pathologist using conventional microscope. Operator’s costs associated with automated quantitative cytology platform vs. conventional reading using light microscope were compared too. The overall costs of operations based on automated platform were proven to be lower.Conclusion: The use of automated platform and artificial intelligence as a means to overcome the lack of cytotechnologists and pathologists and to implement proper quality control in the large scale population based cervical cancer screening seems very promising.

scholarly journals Role of Protein Biomarkers in the Detection of High-Grade Disease in Cervical Cancer Screening Programs

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Charlotte A. Brown ◽  
Johnannes Bogers ◽  
Shaira Sahebali ◽  
Christophe E. Depuydt ◽  
Frans De Prins ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cervical Screening ◽  
False Negative ◽  
Pap Test ◽  
Developed Countries ◽  
Protein Biomarkers ◽  
Ki 67 ◽  
Screening Programs

Since the Pap test was introduced in the 1940s, there has been an approximately 70% reduction in the incidence of squamous cell cervical cancers in many developed countries by the application of organized and opportunistic screening programs. The efficacy of the Pap test, however, is hampered by high interobserver variability and high false-negative and false-positive rates. The use of biomarkers has demonstrated the ability to overcome these issues, leading to improved positive predictive value of cervical screening results. In addition, the introduction of HPV primary screening programs will necessitate the use of a follow-up test with high specificity to triage the high number of HPV-positive tests. This paper will focus on protein biomarkers currently available for use in cervical cancer screening, which appear to improve the detection of women at greatest risk for developing cervical cancer, including Ki-67,p16INK4a, BD ProEx C, and Cytoactiv HPV L1.

scholarly journals Cervical cytochemistry: a potential adjunct to cytomorphology for detection of abnormal cells in cervical cancer screening

2020 ◽  
Vol 10 (1) ◽  
pp. 1639-1644
Author(s):  
Indrani Krishnappa ◽  
Kalyani R. ◽  
Raja Parthiban ◽  
Abhishek Agrawal
Keyword(s):  
Cervical Cancer ◽  
Acid Phosphatase ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cancer Detection ◽  
Pap Smear ◽  
Pap Test ◽  
Low Grade ◽  
Smear Examination ◽  
Intraepithelial Lesion

Background: Pap smear examination has been universally used as an effective screening tool for early detection of cervical carcinoma. The aim of this study was to assess the utility of Cervical Acid Phosphatase staining as an adjunct to routine Pap smear testing to improvethe sensitivity and specificity of routine Pap smear examination for cervical cancer detection. Materials and Methods: Cervical smears were taken from patients attending the gynecology department and a few cervical cancer screening programmes. One set of slides were alcohol fixed and stained with rapid pap stain and another set of slides were fixed in a special fixative and stained with Cervical Acid Phosphatase -Pap stain. The nuclear features of these Cervical Acid Phosphatase stained dysplastic cells was studied on Pap stain to diagnose cervical intraepithelial lesion/ malignancy. Results: Out of 489 cases included in the study 6 cases were diagnosed with intraepithelial lesion/ malignancy. On Cervical Acid Phosphatase -Pap stain 2 of the cases diagnosed as inflammatory smears on pap stain showed Cervical Acid Phosphatase positivity and thus were re evaluated. Mild nuclear atypia was observed in the Cervical Acid Phosphatase positive cells and these cases were diagnosed as Low grade squamous intraepithelial lesion and later biopsy proven to be Cervical intraepithelial Neoplasia I. Therefore Cervical Acid Phosphatase -Pap test was 100% sensitive and specific for cervical cancer detection. Conclusions: With 100% sensitivity Cervical Acid Phosphatase -Pap test satisfies the criteria of an efficient screening test.

Mapping Population Health Management Roadmap into Cervical Cancer Screening Programs

2015 ◽  
Vol 4 (3) ◽  
pp. 1-18 ◽  
Author(s):  
Anastasius Moumtzoglou ◽  
Abraham Pouliakis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Population Health ◽  
Cervical Cancer Screening ◽  
Health Management ◽  
Pap Test ◽  
Population Health Management ◽  
Personalized Care ◽  
Screening Programs ◽  
Care Gaps

Population Health Management (PHM) aims to provide better health outcomes for preventing diseases, closing care gaps and providing more personalized care. Since the inception of the Pap test, cervical cancer (CxCa) decreased in countries applying cervical cancer programs, involving both prevention and treatment. In this article, the authors map the PHM roadmap to the design of cervical cancer screening programs and examine the effect on the supporting information technology systems. Notwithstanding screening programs have a tight relation to PHM; the mapping reveals numerous interventions involving additional data sources, and timeless reconfiguration.

scholarly journals Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing

Viruses ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 729 ◽  
Author(s):  
Andreas Chrysostomou ◽  
Dora Stylianou ◽  
Anastasia Constantinidou ◽  
Leondios Kostrikis
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Screening Method ◽  
Population Based ◽  
Screening Tests ◽  
Screening Methods ◽  
Hpv Testing ◽  
Screening Programs

Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.

Compliance with Breast and Cervical Cancer Screening Programs in Women: Results from a Population-Based Study

2013 ◽  
Vol 99 (5) ◽  
pp. 565-571 ◽  
Author(s):  
Rossana Berardi ◽  
Dania Nacciarriti ◽  
Tiziana Tamburrano ◽  
Giovanna Carbonari ◽  
Emanuela Romagnoli ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Population Based Study ◽  
Screening Programs ◽  
Breast And Cervical Cancer

Cervical cancer screening information flow in Northern regional administrative service in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Portela ◽  
V Cruz ◽  
H Monteiro ◽  
F Tavares
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Information Flow ◽  
Screening Program ◽  
Population Based ◽  
Health Administration ◽  
Screening Programs ◽  
Longitudinal Data Collection ◽  
Northern Regional

Abstract Management of a population-based screening program circuit depends on characteristics and technical barriers of its application and implementation. The aim is to clarify the information flow, to understand and build a vision of cervical screening information flows in Northern Regional Health Administration Portuguese Public System and to identify the constraints among them. A total of 5 cluster meetings were presented and two expert interviews were conducted allowing to present an informational flow and its constraints. Aims addressed in each interview where based on the expertise of the interviewed. Cervical cancer screening program depends on the use of SiiMA application. This is an information system for the management of population-based screening program which involves mainly 3 entities and allows a longitudinal data collection and study. Three main constraints were reported. The time for updating data for the list of eligible women was bigger than accorded reaching up to 3 months delay. A duplicate of records and discharges in hospital care since the discharge was done both in the hospital system and the SiiMA platform manually in order to the woman re-enter the screening program. Pendencies were seen due to other screening programs running in parallel which had to be sorted out manually in the regional level or by the entity involved. The existence of a screening application is vital for the implementation purposes of a screening program. The lack of integration of the systems increases bureaucratic work, costs and causes time delay. To improve the efficiency of digital transformation ensuring the quality of the process it is necessary to adapt the design of the health informatic systems to the daily practice and its wants and needs. The strategies of forcing an ever-increasing number of frameworks have demonstrated not to be so effective. Therefore, it is a cornerstone to understand these flows in order to improve its structure, intervention and optimization. Key messages The existence of a screening digital application is vital but its expanding use arises constraints. Due to the complexity of such programs, a digital strategy is crucial for management and monitoring of the screening at this scale.

Quality Indicators for Cervical Cancer Screening Programs

2014 ◽  
Vol 3 (4) ◽  
pp. 19-37 ◽  
Author(s):  
Elena Athanasiadi ◽  
Abraham Pouliakis ◽  
Evripidis Bilirakis ◽  
Vassilis Fragoulakis ◽  
Constantinos Bilirakis ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Quality Assurance ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Quality Indicators ◽  
Performance Indicators ◽  
Screening Programs ◽  
European Guidelines ◽  
Screening Services ◽  
And Performance

Cervical cancer is the malignancy most succesfully monitored by screening programs. Although most counties offer screening services, outcomes differ. It is clear that incidence reduction is achieved when quality assurance is implemented. Quality indicators are essential audit tools when implementing screening policies. Uniform indicators are used to monitor general performance and to identify potential problems that may occur and jeopardise efforts. That way quality management is enabled and the assessment of deviation from goals is facilitated. In this paper the authors present the workflow of cervical cancer screening programs in respect to the quality and performance indicators required by the European Guidelines for Quality Assurance in Cervical Cancer Screening. The authors also propose the appropriate data structures and entities that are required for a computerised system to support their calculation. Additionally the authors highlight important interconnections of the computerised system with other systems; these interconnections are vital for the calculation of the proposed quality indicators.

scholarly journals Canadian cancer screening disparities: a recent historical perspective

2015 ◽  
Vol 22 (2) ◽  
pp. 156 ◽  
Author(s):  
J. Kerner ◽  
J. Liu ◽  
K. Wang ◽  
S. Fung ◽  
C. Landry ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Low Income ◽  
Cancer Mortality ◽  
Pap Test ◽  
Screening Programs ◽  
Screening Services

Across Canada, introduction of the Pap test for cervical cancer screening, followed by mammography for breast cancer screening and, more recently, the fecal occult blood test for colorectal cancer screening, has contributed to a reduction in cancer mortality. However, another contribution of screening has been disparities in cancer mortality between certain populations. Here, we explore the disparities associated with breast and cervical cancer screening and preliminary data concerning disparities in colorectal cancer screening.Although some disparities in screening utilization have been successfully reduced over time (for example, mammography and Pap test screening in rural and remote populations), screening utilization data for other populations (for example, low-income groups) clearly indicate that disparities have existed and continue to exist across Canada. Organized screening programs in Canada have been able to successfully engage 80% of women for regular cervical cancer screening and 70% of women for regular mammography screening, but of the women who remain to be reached or engaged in regular screening, those with the least resources, those who are the most isolated, and those who are least culturally integrated into Canadian society as a whole are overrepresented. Population differences are also observed for utilization of colorectal cancer screening services.The research literature on interventions to promote screening utilization provides some evidence about what can be done to increase participation in organized screening by vulnerable populations. Adaption and adoption of evidence-based screening promotion interventions can increase the utilization of available screening services by populations that have experienced the greatest burden of disease with the least access to screening services.

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