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. 2019 Jun;26(3):e286-e291.
doi: 10.3747/co.26.4709. Epub 2019 Jun 1.

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

K Decker  1   2 , N Baines  3 , C Muzyka  4 , M Lee  5 , M H Mayrand  6 , H Yang  7 , S Fung  3 , D Mercer  8 , S McFaul  9 , R Kupets  10 , R Savoie  11 , R Lotocki  12 , J Bentley  13
Affiliations

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

K Decker et al. Curr Oncol. 2019 Jun.

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.

Keywords: Colposcopy; mass screening; quality of health care.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES We have read and understood Current Oncology’s policy on disclosing conflicts of interest, and we declare the following interests: SM reports grants and other fees from Merck outside the submitted work, and ML reports personal fees from Merck outside the submitted work. The remaining authors have no conflicts to disclose.

Figures

FIGURE 1
FIGURE 1
Cervical cancer screening pathway and colposcopy quality indicators.
See this image and copyright information in PMC

References

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