Is it feasible to enhance quality assurance of cervical cancer screening in Latin America? A regional expert consensus.

IF 2.6 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Medical Screening Pub Date : 2023-12-01 Epub Date: 2023-06-08 DOI:10.1177/09691413231178253
Valentina Rangel, Ginna Paola Fernández-Deaza, Juan Sebastián Castillo, Raúl Murillo
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引用次数: 0

Abstract

Objectives: Cervical cancer elimination requires high-performance screening tests and high treatment rates, and thus high screening program performance is essential; however, Latin America lacks organized screening and quality assurance (QA) guidelines. We aimed to develop a core set of QA indicators suitable to the region.

Methods: We reviewed QA guidelines from countries/regions with highly organized screening programs and selected 49 indicators for screening intensity, test performance, follow-up, screening outcomes and system capacity. A regional expert consensus using the Delphi method in two rounds was implemented to identify basic indicators actionable within the regional context. The panel was integrated by recognized Latin American scientists and public health experts. They voted for the indicators blinded to each other based on feasibility and relevance. The correlation between both attributes was analyzed.

Results: In the first round 33 indicators reached consensus for feasibility but only 9 for relevance, without full coincidence. In the second round 9 indicators met the criteria for both (2 screening intensity, 1 test performance, 2 follow-up, 3 outcomes, 1 system capacity). A significant positive correlation was observed for test performance and outcomes indicators between the two attributes assessed (p < 0.05).

Conclusions: Cervical cancer control requires realistic goals supported by proper programs and QA systems. We identified a set of indicators suitable to improve cervical cancer screening performance in Latin America. The assessment by an expert panel with a joint vision from science and public health practice represents a significant progress towards real and feasible QA guidelines for countries in the region.

在拉丁美洲加强子宫颈癌普查的质量保证是否可行?区域专家共识。
目的:消除宫颈癌症需要高性能的筛查测试和高治疗率,因此高筛查计划的性能至关重要;然而,拉丁美洲缺乏有组织的筛查和质量保证(QA)指南。我们的目标是制定一套适合该地区的核心质量保证指标。方法:我们审查了来自具有高度组织化筛查项目的国家/地区的QA指南,并选择了49个筛查强度、测试性能、随访、筛查结果和系统能力指标。采用德尔菲方法分两轮达成区域专家共识,以确定在区域范围内可采取行动的基本指标。该小组由公认的拉丁美洲科学家和公共卫生专家组成。他们根据可行性和相关性投票支持彼此视而不见的指标。分析了两个属性之间的相关性。结果:在第一轮中,33项指标的可行性达成了共识,但相关性只有9项,并非完全一致。在第二轮中,有9项指标符合这两项标准(2项筛查强度、1项测试表现、2项随访、3项结果、1项系统能力)。两个评估属性之间的测试表现和结果指标之间存在显著的正相关(p 结论:宫颈癌症控制需要现实的目标支持适当的程序和质量保证系统。我们确定了一套适合提高拉丁美洲癌症宫颈癌筛查绩效的指标。由一个具有科学和公共卫生实践共同愿景的专家小组进行的评估代表着该地区各国在实现真正可行的QA指南方面取得了重大进展。
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来源期刊
Journal of Medical Screening
Journal of Medical Screening 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.90
自引率
3.40%
发文量
40
审稿时长
>12 weeks
期刊介绍: Journal of Medical Screening, a fully peer reviewed journal, is concerned with all aspects of medical screening, particularly the publication of research that advances screening theory and practice. The journal aims to increase awareness of the principles of screening (quantitative and statistical aspects), screening techniques and procedures and methodologies from all specialties. An essential subscription for physicians, clinicians and academics with an interest in screening, epidemiology and public health.
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