Proposal to institutionalize criteria and quality standards for cervical cancer screening within a health care system.
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 institutionalizing 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.
Salmerón-Castro
J
J
Unidad de Investigación Epidemiológica y en Servicios de Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Avenida Cuahutemoc 330, Unidad de Congresos, Bloque B, 4o piso, México, D. F., C. P. 06720, México.
Kazcano Ponce
E C
EC
Pérez Cuevas
R
R
del Río Gómez
I
I
Torres Torija
I
I
Hernández Avila
M
M
D000328:Adult; D000368:Aged; D003127:Colposcopy / Q000592:standards; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration / Q000592:standards*; D008800:Mexico; D008875:Middle Aged; D018579:Patient Selection; D011159:Population Surveillance / Q000379:methods; D011786:Quality Control; D012042:Registries / Q000592:standards; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D014626:Vaginal Smears / Q000592:standards; D014932:Women's Health Services / Q000458:organization & administration / Q000592:standards*