This article describes a general framework for improving the quality of statistical programs in organizations that provide a continual flow of statistical products to users and stakeholders. The work stems from a 2011 mandate to Statistics Sweden issued by the Swedish Ministry of Finance to develop a system of quality indicators for tracking developments and changes in product quality and for achieving continual improvements in survey quality across a diverse set of key statistical products. We describe this system, apply it to a number of products at Statistics Sweden, and summarize key results and lessons learned. The implications of this work for monitoring and evaluating product quality in other statistical organizations are also discussed.

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Background Cervical carcinoma (CIN) is typically detected through pathological tissue changes at the squamous-columnar epithelial transition zone. As the disease advances, it may extend into the uterine cavity, vaginal canal and pelvis. Cancer screen is routinely done via Papanicolaou smear test. In a majority of cases where pre-cancerous lesions (CIN Stages I, II, and III) are detected by cytology, associated signs and symptoms are absent. Usually, once symptoms present, the disease has spread extensively. 2−4 Risk factors for cervical cancer include tobacco use, immunocompromised status, family history of cervical cancer, sexual contact without barrier protection, low social economic status and multiple full-term pregnancies. Additionally, a known causative agent for cervical cancer is human papillomavirus (HPV). In order to avoid contributory effects from such risk factors and causative agents, clinicians recommend regular cervical cytologic screening, completing the HPV immunization series, routine condom use, and smoking cessation. 3−6 Treatment and diagnosing modalities used in current practice for cervical carcinoma include cone biopsy, loop electrosurgical excision procedure (LEEP), laser and cold knife conization and simple hysterectomy. If the cervical malignancy r is found to be in an advanced stage, it may be necessary to perform a radical hysterectomy via laparotomy or laparoscopy with concomitant localized radiation therapy and/or chemotherapy for widespread disease. 1,5,7 Traditionally, cervical cancer was managed by the previously mentioned techniques; with advancements the Single-Incision Laparoscopic Surgery (SILS) has a high efficacy rate with a minimally invasive approach. 1,8,9 Single-Incision Laparoscopic Surgery (SILS) is one of latest innovations in minimally invasive surgery and has several potential

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