Elfström K Miriam, Arnheim-Dahlström Lisen, von Karsa Lawrence, Dillner Joakim
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden.
Quality Assurance Group, Early Detection and Prevention Section, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon CEDEX 08, France.
Eur J Cancer. 2015 May;51(8):950-68. doi: 10.1016/j.ejca.2015.03.008. Epub 2015 Mar 25.
Cervical screening programmes have reduced cervical cancer incidence and mortality but the level of success is highly variable between countries. Organisation of programmes is essential for equity and cost-effectiveness. However, there are differences in effectiveness, also among organised programmes. In order to identify the key organisational components that determine effectiveness, we performed a Europe-wide survey on the current status of organisation and organised quality assurance (QA) measures in cervical cancer prevention programmes, as well as organisation-associated costs.
A comprehensive questionnaire was developed through systematic review of literature and existing guidelines. The survey was sent to programme organisers, Ministries of Health and experts in 34 European Union (EU) and European Free Trade Agreement (EFTA) countries. Detailed aspects of programme organisation, quality assurance, monitoring, evaluation and corresponding line-item costs were recorded. Documentation of programme guidelines, protocols and publications was requested.
Twenty-nine of 34 countries responded. The results showed that organised efforts for QA, monitoring and evaluation were carried out to a differing extent and were not standardised, making it difficult to compare the cost-effectiveness of organisation and QA strategies. Most countries found it hard to estimate the costs associated with launching and operating the organised programme.
To our knowledge, this is the first questionnaire to request detailed information on the actual organisation and QA of programmes. The results of this survey can be used as a basis for further development of standardised guidelines on organisation and QA of cervical cancer screening programmes in Europe.
宫颈癌筛查项目已降低了宫颈癌的发病率和死亡率，但各国的成功程度差异很大。项目的组织对于公平性和成本效益至关重要。然而，即使在组织起来的项目中，其有效性也存在差异。为了确定决定有效性的关键组织要素，我们对欧洲范围内宫颈癌预防项目的组织现状、组织化质量保证（QA）措施以及与组织相关的成本进行了一项调查。
通过对文献和现有指南的系统回顾，制定了一份全面的问卷。该调查问卷被发送给34个欧盟（EU）和欧洲自由贸易协定（EFTA）国家的项目组织者、卫生部和专家。记录了项目组织、质量保证、监测、评估的详细方面以及相应的明细成本。要求提供项目指南、方案和出版物的文件。
34个国家中有29个做出了回应。结果表明，质量保证、监测和评估的组织工作开展程度不同且未标准化，这使得难以比较组织和质量保证策略的成本效益。大多数国家发现难以估计启动和运营组织化项目的相关成本。
据我们所知，这是第一份要求提供项目实际组织和质量保证详细信息的问卷。本次调查结果可作为进一步制定欧洲宫颈癌筛查项目组织和质量保证标准化指南的基础。
