Quality control assurance in national screening programmes for cervical cancer

The United Kingdom established a centrally controlled formal screening programme for cervical cancer in 1988. The programme has been an unprecedented success, with the incidence of cervical cancer falling by an accelerated rate of 7% a year. Underlying the success of the programme is a rigorous system of quality assurance at all levels of activity. Quality assurance assessment in performed for coverage of the target population, cytology reporting laboratories and colposcopy services. Each component in the system is examined annually by mandatory returns, and by regular on-site review of the clinical services by independent authorities. Processes also exist to establish and maintain the competency of all clinical and non-clinical staff involved in the programme. Using nationally published figures from the financial year 2001/2002, the different quality assurance strategies are described. The future development of quality assurance in the programme is then discussed.