Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system

Abstract

The uterine cervix is the most common cancer site for females. Approximately 52,000 new cases occur annually in Latin America, thus the need to improve efficiency and effectiveness of Cervical Cancer Screening Programs (CCSP) is mandatory to decrease the unnecessary suffering women must bear. This paper is addressing essential issues to revamp the CCSP as proposed by the Mexican official norm. A general framework for institutionaling CCSP is outlined. Furthermore, strategies to strengthen CCSP performance through managerial strategies and quality assurance activities are described. The focus is on the following activities: 1) improving coverage; 2) implementing smear-taking quality control; 3) improving quality in interpretation of Pap test; 4) guaranteeing treatment for women for whom abnormalities are detected; 5) improving follow-up; 6) development of quality control measures and 7) development of monitoring and epidemiological surveillance information systems. Changes within the screening on cervical cancer may be advocated as new technologies present themselves and shortcomings in the existing program appear. It is crucial that these changes should be measured through careful evaluation in order to tally up potential benefits.

Design and methods of the evaluation of an HPV-based cervical cancer screening strategy in Mexico: the Morelos HPV study

“…Well-defined guidelines for triage, diagnosis and management of cervical abnormalities and case surveillance have also been established. 24 Finally, a computerized surveillance system has been created to monitor the IMSS CCSP in Morelos.…”

Avaliação dos Métodos Empregados no Programa Nacional de Combate ao Câncer do Colo Uterino do Ministério da Saúde

“…Tais procedimentos também fundamentam as conclusões do "National Workshop on Screening for Cancer of the Cervix" 15 , conferência de especialistas que analisou o programa nacional canadense de rastreamento do câncer do colo do útero e a base do programa de rastreamento cervical mexicano implantado em 1998 16 . O PNCC foi a primeira iniciativa expressiva do Ministério da Saúde do Brasil, no combate ao câncer cervical invasivo.…”