title: Performance indicators of organized cervical screening in Romagna (Italy).
abstract: The availability of published data from organized cervical screening programmes in southern Europe is scant. In the Italian area of Romagna, a first round of organized screening (based on a 3-yearly Pap smear for women aged 25-64 years) was initiated between December 1995 and January 1997 and was completed in an average of 42 months (range 36-48 months). The target population included 305 478 women. Of these, 253 949 were eligible and received a personal letter of invitation. Age-specific screening performance indicators were calculated according to standard methods. The response rate within 6 months of invitation was 49.1% (n=124 621). The total participation rate including women who presented later was 61.7% (n=156 735). The recall rate was 35.2 per 1000 of participants (n=5514). Positive cytology results were distributed as follows: atypical squamous cells of un-determined significance/atypical glandular cells of undetermined significance (ASCUS/AGUS) 40.1%, low-grade squamous intraepithelial neoplasia (LGSIL) 48.6%, high-grade squamous intraepithelial neoplasia (HGSIL) 10.7% and carcinoma 0.7%. Compliance to colposcopy follow-up was 93.4% (n=5149). The biopsy rate was 52.4% (n=2696) of patients undergoing colposcopy. The detection rate was 4.5 per 1000 of participants (n=707) for CIN2-3 and 0.5 (n=75) for invasive carcinoma. The proportion of microinvasive carcinomas was 36.0% (n=27). The positive predictive value for CIN2-3/carcinoma was 5.8% for the cytology reports of ASCUS/AGUS, 7.6% for those of LGSIL, 76.5% for those of HGSIL, and 100.0% for those of carcinoma (80.4% for combined HGSIL/carcinoma). The ratio of observed to expected (or prevalent to incident) cases of invasive carcinoma was 2.35 (95% confidence interval (CI) 1.85-2.95). In conclusion, most early results of the programme were compatible with an acceptable performance.
authors.affiliation: Romagna Cancer Registry, Medical Oncology Department, Luigi Pierantoni Hospital, 47100 Forlì, Italy. l.bucchi@ausl.fo.it
authors.forename: L
authors.initials: L
authors.lastname: Bucchi
authors.forename: F
authors.initials: F
authors.lastname: Falcini
authors.forename: P
authors.initials: P
authors.lastname: Schincaglia
authors.forename: F
authors.initials: F
authors.lastname: Desiderio
authors.forename: A
authors.initials: A
authors.lastname: Bondi
authors.forename: M
authors.initials: M
authors.lastname: Farneti
authors.forename: D
authors.initials: D
authors.lastname: Casadei Giunchi
authors.forename: M
authors.initials: M
authors.lastname: Serafini
authors.forename: D
authors.initials: D
authors.lastname: Canuti
authors.forename: L
authors.initials: L
authors.lastname: Caprara
authors.forename: F
authors.initials: F
authors.lastname: Sabbadini
authors.forename: F
authors.initials: F
authors.lastname: Monari
authors.forename: P
authors.initials: P
authors.lastname: Sassoli
mesh_terms: D000328:Adult; D000367:Age Factors; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D003127:Colposcopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D065006:Papanicolaou Test; D010349:Patient Compliance; D015995:Prevalence; D019984:Quality Indicators, Health Care; D013223:Statistics as Topic; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014626:Vaginal Smears; D016387:Women's Health; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000473:pathology