European Guidelines for Quality Assurance in Cervical Cancer Screening. Second Edition—Summary Document

Abstract

European Guidelines for Quality Assurance in Cervical Cancer Screening have been initiated in the Europe Against Cancer Programme. The first edition established the principles of organised population-based screening and stimulated numerous pilot projects. The second multidisciplinary edition was published in 2008 and comprises ∼250 pages divided into seven chapters prepared by 48 authors and contributors. Considerable attention has been devoted to organised, population-based programme policies which minimise adverse effects and maximise benefits of screening. It is hoped that this expanded guidelines edition will have a greater impact on countries in which screening programmes are still lacking and in which opportunistic screening has been preferred in the past. Other methodological aspects such as future prospects of human papillomavirus testing and vaccination in cervical cancer control have also been examined in the second edition; recommendations for integration of the latter technologies into European guidelines are currently under development in a related project supported by the European Union Health Programme. An overview of the fundamental points and principles that should support any quality-assured screening programme and key performance indicators are presented here in a summary document of the second guidelines edition in order to make these principles and standards known to a wider scientific community.

European guidelines for quality assurance in colorectal cancer screening and diagnosis: Overview and introduction to the full Supplement publication

“…Although the risks may be slight, they add up in the large number of people exposed to screening. Effective quality assurance ensures that the balance between the collective risk and the achieved benefit remains acceptable.Experience gained from piloting and implementing numerous cancer screening programmes in the EU confirms the well-known observation that overall screening outcome depends on the level of performance at each step in the process of screening [3,[13][14][15][16][41][42][43]; see also [44]. To maximize the benefit and minimize the risk of CRC screening, quality must be optimal throughout the process, and that includes the identification and personal invitation of the target population, the performance of the screening test and, if necessary, the diagnostic work-up of screen-detected lesions, and treatment, surveillance and aftercare [2,3].…”

“…Personal invitation aims to give each eligible person an equal chance of benefiting from screening and thereby reduce health inequalities. As with evidence-based screening for breast or cervical cancer, the population-based approach to programme implementation is also recommended for CRC screening because it provides an organizational framework conducive to effective management and continuous improvement of the screening process, such as through linkage with population and cancer registries for optimization of invitation to screening and for evaluation of screening performance and impact [3,[13][14][15][16][17]. Nationwide implementation of population-based screening programmes makes services performing to high standards available to the entire population eligible to attend screening.…”

“…The EU policy takes into account the principles of cancer screening developed by the World Health Organization [12] and the extensive experience in the EU in piloting and implementing population-based cancer screening programmes [13]. Comprehensive European quality assurance guidelines for breast and cervical cancer screening have been developed by experts and published by the EU [14,15]. The new European guidelines for quality assurance in colorectal cancer screening and diagnosis [3,[16][17][18][19][20][21][22][23][24][25][26][27]] make similar principles, standards and recommendations available to healthcare professionals, scientists, decision-makers and other stakeholders seeking to establish or improve CRC screening programmes.…”

Factors Associated with Decisions to Attend Cervical Cancer Screening among Women Aged 30-60 Years in Chatapadung Contracting Medical Unit, Thailand

“…Women who have not had abnormal smears can stop screening about age 60 to 70 (Saslow, 2002). The incidence of cervical cancer could be reduced up to 80% by Pap smear screening every 3-5 years with an appropriate follow-up (Arbyn et al, 2010), however, participation in these screening programs varies according to women's personal and social characteristics.…”

Impacto da capacitação dos profissionais de saúde sobre o rastreamento do câncer do colo do útero em unidades básicas de saúde

“…Os Estados Unidos da América indicavam o rastreio após o início da atividade sexual; a partir de 2002, o país passou a adotar o prazo de 3 anos, com limite máximo aos 21 anos 20 . Na Europa, é recomendado que o rastreamento inicie entre 25 e 30 anos de idade 21 .…”