Download Cervical Cancer Screening Participation Rate

Performance Measure Definition
Alberta Health
Cervical Cancer Screening Participation Rate
Name and Definition
Full Name
Percentage of women 21-69 who have a Pap test in the last three years
Short Name
Cervical Cancer Screening Participation Rate
Definition
Screening rates for cervical cancer for eligible women aged 21–69 years in a three-year period
Domain
Health Services Delivery
Dimension
Acceptability
Efficiency
Appropriateness
No
No
Yes
Effectiveness
Accessibility
Safety
No
No
No
Category of Measure
Emerging-Strategic
Type of Measure
Process Measure
Other Comments / Notes
Context
Business Context
Rationale
AHS Quality & Patient Safety Dashboard
The Quality and Patient Safety Committee of the Board requested the development of a Quality
and Patient Safety Dashboard to enable the monitoring of the quality of services provided by
Alberta Health Services (AHS).
According to the Guideline for Screening for Cervical Cancer:
“More than 45 types of human papillomavirus (HPV) are transmitted by intimate sexual contact,
and persistent infection with a carcinogenic type is necessary for cervical cancer to develop.
HPV is transmitted so easily that the lifetime cumulative prevalence of high-risk infection
approaches 80%. Most of these infections resolve without symptoms and without treatment. A
woman’s immune system generally clears the virus, in which case any cervical cell changes the
HPV infection may have caused resolve on their own. When the virus is not cleared, persistent
carcinogenic HPV infection may cause precancerous tissue changes that can, over many
years, progress to invasive cervical cancer. Early detection and treatment during this lengthy
precancerous stage can prevent the vast majority of cervical cancer.
Failure to be screened and being under-screened continue to be major risk factors for cervical
cancer in Alberta.”
Notes for Interpretation
Organizational Strategy
Benchmark Comparisons
© Government of Alberta
Wednesday, February 19, 2014
AHS Targets:
2010 – 70% of women in target age group are screened every three years.
2015 – 75% of women in target age group are screened every three years.
2020 – 80% of women in target age group are screened every three years.
Women who are not eligible for Pap tests due to hysterectomy are not currently removed from
the denominator. This leads to an underestimate in the screening participation rate.
The time period for the metric is based on a calendar year.
• Actively engage women, families, and primary care providers as partners in system
improvements.
• Focus on reducing disparities in uptake, and continue to develop and implement community
action plans and social marketing approaches.
• Strategies to increase adoption of provincial screening guidelines in clinical practice and
physician workforce
National or International comparisons available:
Canada: 3 - year participation rate: 67% - 74%
Australia: 3 - year participation rate: 74%
(Links available in Planning Documents section of this form)
Page 1 of 3
Performance Measure Definition
Alberta Health
Cited References
Guidelines for Screening for Cervical Cancer, Toward Optimized Practice (TOP), 2009. (link
available in Planning Documents section of this form)
Technical Specifications
Metric
Percentage calculation based on individual woman (See Notes section of this form for add'l
details)
Rates are displayed with one decimal point.
Preferred
Display Format
Numerator
Number of eligible women aged 21-69 screened at least once (per 3 year period)
Inclusion Female, aged 21-69 at time of service, lives in Alberta at time of service, Pap test(s) is
Criteria for performed within the 3-year reporting period
Numerator
Exclusion None
Criteria for
Numerator
Data Source(s) Alberta Health Fee-for-Service (FFS) data
for
Numerator The Alberta Cervical Cancer Screening Program (ACCSP) database will become the primary
data source once it is established.
Refresh Rate Alberta Health FFS data is available for reporting annually (see Notes section for add'l detail)
for
Numerator
Data Steward Alberta Health
for
Numerator ACCSP - once the provincial cervical screening database becomes available.
Denominator
Number of women aged 21–69 years at year two of the three-year reporting period
Inclusion Number of women aged 21-69 years at year two
Criteria for
Denominator
Exclusion None
Criteria for
Denominator
Data Source(s) Alberta Health Care Insurance Plan Stakeholder Registry
for
Denominator
Refresh Rate Population estimates are estimated as of mid-year (June 30 each year) by Alberta Health using
for Alberta Health Care Insurance Plan Stakeholder Registry.
Denominator
Data Steward Alberta Health
for
Denominator
Technical
Data are available annually in June for the preceding three years.
Notes
Calculation
Number of women (age 21-69) with at least one Pap test in a three-year period
___________________________________________________________________________________________
Number of women in the target population (age 21-69) at year two of the three-year period
X 100
Relationship to Retention Rate, Pre-Cancer Detection Rate (These indicators are not included currently but
Other
may be in the future.)
Indicators
Level of
National No
Provincial
Zone
Site
Yes
Yes
No
Reporting
Reporting
Notes
Frequency of Annually Yes
Quarterly
Monthly
Other
No
No
No
Reporting
Other
Reporting
Frequency
Limitations
Data is currently available for (former) Calgary and Palliser regions only through Alberta
Cervical Cancer Screening Program. This is expected to be available for the entire province,
© Government of Alberta
Wednesday, February 19, 2014
Page 2 of 3
Performance Measure Definition
Alberta Health
once provincial database is established; however, retrospective data will remain sourced
through Alberta Health FFS data. For the other (former) regions, data source will be the
number of distinct women screened once every three years per Alberta Health FFS data.
Planning Documents
Reference Documents
Name
Business Planning Document URL
Australia:
http://www.health.gov.au/internet/screening/publishing.nsf/Content/facts
Canada:
http://www.phac-aspc.gc.ca/publicat/ccsic-dccuac/index-eng.php
Guidelines for Screening for Cervical http://www.topalbertadoctors.org/cpgs.php?sid=2&cpg_cats=15
Cancer, Toward Optimized Practice
(TOP), 2009.
United Kingdom
© Government of Alberta
Wednesday, February 19, 2014
http://www.cancerscreening.nhs.uk/cervical/publications/2008review.html
Page 3 of 3