Report of the 2003 pan-Canadian forum on cervical cancer prevention and control.
OBJECTIVE
To develop evidence-based consensus recommendations on the delivery of cervical cancer screening, human papillomavirus (HPV) education, HPV testing, and the optimal tool for cervical cytology within the Canadian health system.


METHODS
Leading up to a forum held in Ottawa on November 21 and 22, 2003, 254 registrants reviewed position papers through a Web-based discussion group. Experts in program management, clinical practice, epidemiology, public health, economics, and women's health, representing 48 organizations, then participated in the 2-day forum to develop consensus recommendations.


METHODS
Writing groups prepared position papers on optimal methods for cervical cytology; education concerning HPV; HPV testing in primary screening; HPV testing as a triage tool in cytopathology; and delivery mechanisms for cervical screening. Systematic reviews were the primary source of evidence supplemented by literature searches.


METHODS
Feedback from Web-based discussions was incorporated into consecutive drafts of position papers. At the forum, recommendations and supporting evidence were presented, further debated in small-group sessions, and discussed in a plenary session. Despite divergent professional mandates and opinions, consensus was achieved on 15 recommendations across all areas. Final recommendations were posted to the Web for further input and circulated for written consensus by participants.


CONCLUSIONS
The recommendations cover the use of new evidence and technologies in cervical cancer prevention in Canada and provide a framework for provision of HPV education, planning the implementation of new cervical screening technologies in Canada, the development of evaluation plans, and new research areas.
Stuart
Gavin
G
Faculty of Medicine, University of British Columbia, Vancouver BC. gstuart@medd.med.ubc.ca
Taylor
Gregory
G
Bancej
Christina M
CM
Beaulac
Jennifer
J
Colgan
Terence
T
Franco
Eduardo L
EL
Kropp
Rhonda Y
RY
Lotocki
Robert
R
Mai
Verna
V
McLachlin
C Meg
CM
Onysko
Jay
J
Martin
Ruth Elwood
RE
Elit
Laurie
L
Guijon
Fernando
F
Mann
Janice
J
Ogilvie
Gina
G
Romanowski
Barbara
B
Tromp
Margaret
M
D002170:Canada; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000517:prevention & control; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000517:prevention & control; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000517:prevention & control; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears