Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia.
Pontificia Universidad Javeriana, Bogotá, Colombia.
J Med Screen. 2023 Dec;30(4):201-208. doi: 10.1177/09691413231178253. Epub 2023 Jun 8.
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.
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.
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 ( < 0.05).
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.
宫颈癌消除需要高性能的筛查测试和高治疗率，因此筛查项目的高绩效至关重要；然而，拉丁美洲缺乏有组织的筛查和质量保证 (QA) 指南。我们旨在制定一套适合该地区的核心 QA 指标。
我们回顾了具有高度组织性筛查计划的国家/地区的 QA 指南，并选择了 49 个用于筛查强度、检测性能、随访、筛查结果和系统能力的指标。采用两轮德尔菲法进行区域专家共识，以确定在区域背景下可行的基本指标。该小组由拉丁美洲知名科学家和公共卫生专家组成。他们根据可行性和相关性对彼此盲目的指标进行投票。分析了这两个属性之间的相关性。
在第一轮中，有 33 个指标在可行性方面达成共识，但只有 9 个指标在相关性方面达成共识，两者并未完全一致。在第二轮中，有 9 个指标同时符合两个标准（2 个筛查强度、1 个检测性能、2 个随访、3 个结果、1 个系统能力）。评估的两个属性之间的检测性能和结果指标存在显著正相关（<0.05）。
宫颈癌控制需要有现实目标的支持，这些目标需要有适当的项目和 QA 系统来支持。我们确定了一组适合提高拉丁美洲宫颈癌筛查绩效的指标。由具有科学和公共卫生实践共同愿景的专家小组进行评估，是朝着为该地区国家制定真实可行的 QA 指南迈出的重要一步。
