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Process performance of cervical screening programmes in Europe.

Guglielmo Ronco1, Marjolein van Ballegooijen, Nikolaus Becker

  • 1Unit of Cancer Epidemiology, Centre for Cancer Prevention , Via San Francesco da Paola 31, 1023 Torino, Italy. guglielmo.ronco@cpo.it

European Journal of Cancer (Oxford, England : 1990)
|August 29, 2009
PubMed
Summary

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This summary is machine-generated.

European cervical screening programs show significant variation in performance indicators like abnormal test rates and referral protocols. Standardization of classifications and data registration is crucial for improving quality, especially with new technologies.

Area of Science:

  • Public Health
  • Gynecologic Oncology
  • Health Services Research

Background:

  • Cervical cancer screening programs across Europe exhibit considerable heterogeneity in their operational and performance metrics.
  • Existing European Union (EU) guidelines provide a framework for evaluating these screening programs.

Purpose of the Study:

  • To compare key performance indicators (KPIs) across 15 European national or regional cervical screening programs.
  • To identify variations in cytological results, referral rates, and diagnostic yields.
  • To inform strategies for improving cervical screening effectiveness.

Main Methods:

  • Collected standardized data from 15 European cervical screening programs.
  • Computed key performance indicators based on EU Guidelines, 2nd edition.

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  • Analyzed variations in abnormal test proportions, referral rates, and Positive Predictive Value (PPV).

    • Main Results:

    • Wide variations observed in the proportion of abnormal cytological tests (1.2% to 11.7%) and their grading.
    • Referral rates for repeat cytology (2.9% to 16.6%) and colposcopy (0.8% to 4.4%) varied significantly, influenced by management protocols for ASCUS and LSIL.
    • Positive Predictive Value (PPV) for colposcopy showed marked variability (8% to 52%).
    • CIN2+ histology detection rates ranged from <0.1% to >1%.
    • Lower colposcopy attendance noted in some Eastern European countries.
    • Programs with longer operational history demonstrated better overall quality.

    Conclusions:

    • Significant variability exists in European cervical screening program performance, necessitating standardization.
    • Standardization of cytological and histological classifications and data registration systems is essential.
    • These comparative data are valuable for enhancing cervical screening, particularly with the advent of new technologies and HPV vaccination.