title: Performance measures related to colposcopy for canadian cervical cancer screening programs: identifying areas for improvement.
abstract: OBJECTIVE
  To describe performance measures related to colposcopic examinations in Canadian cervical cancer screening programs; specifically, time to colposcopy, histological investigation rate, and agreement between cytology and histology.
  
  
  METHODS
  As part of a national report on the performance of cervical cancer screening, aggregate provincial cervical cancer screening data provided by provinces to the Pan-Canadian Cervical Screening Network were used to evaluate colposcopy program performance measures for women 20 to 69 years of age who had a Pap test in 2009 and 2010.
  
  
  RESULTS
  A total of 37 523 women had a high-grade or more severe Pap test result. The proportion of women who had a colposcopy ≤ 90 days after their Pap test ranged from 30.9% to 51.5%. Fewer women 60 to 69 years of age had a colposcopy than women in younger age groups. The proportion of women who had a high-grade or more severe Pap test result and colposcopy who had a biopsy within 12 months ranged from 82.1% to 96.5%. The proportion of biopsy results that agreed with the Pap test result ranged from 59.5% to 82.1%.
  
  
  CONCLUSIONS
  The time from having a high-grade Pap test result to undergoing colposcopy must be reduced to lower the risk of adverse outcomes and the stress associated with delayed follow-up. The agreement between screening cytology and histology meets the national target of ≥ 65%. Although six of 13 provinces and territories provided data for colposcopy-related performance measures, more information is needed to assess colposcopy services accurately at the national level.
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg MB; Screening Programs, CancerCare Manitoba, Winnipeg MB.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Decker
authors.affiliation: London Health Sciences Centre, London ON.
authors.forename: C Meg
authors.initials: CM
authors.lastname: McLachlin
authors.affiliation: Screening Programs, CancerCare Manitoba, Winnipeg MB; Division of Gynecologic Oncology, University of Manitoba, Winnipeg MB.
authors.forename: Robert
authors.initials: R
authors.lastname: Lotocki
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data; D002170:Canada; D003127:Colposcopy / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D065006:Papanicolaou Test; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears / Q000706:statistics & numerical data; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology
keywords: cervical cancer; cervical cytology; colposcopy; screening