QUALITY-CONTROL INDICATORS AND STANDARDS USED IN DETECTION AND TREATMENT OF PRECANCEROUS LESIONS OF THE UTERINE CERVIX
Abstract
Background. In Slovenia the high incidence of cervical cancer after 1990 is unacceptable knowing that the local passive screening programme efficiently decreased the incidence of cervical cancer in the 1970', and that at present a well branched network of gynecologists and cytologists is available.
Methods. The analysis of measures and actual situation in developed countries, national studies, analyses and numerous evidence-based conclusions published in Slovenia and worldwide, have resulted in the set of most probable causes of the increased incidence of cervical cancer in Slovenia.
Conclusions. Some most relevant measures for decreasing the occurrence of cervical cancer have been planned and some have also been undertaken. The planned goals could be realized in a 5- to 8-year period, under certain conditions: if examination of the Slovene female population strictly following the criteria for efficient active screening is guaranteed, and if most relevant diagnostic procedures in the fields of gynecology and cytology are improved according to the prepared protocols and recommendations.
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References
Register raka Slovenije. Letno poročilo. Ljubljana: Onkološki inštitut, 1979, 1985, 1993, 1999, 2000.
Kovačič J. Epidemiološki pomen zgodnje citološke detekcije karcinoma materničnega vratu. Disertacija. Ljubljana: Medicinska fakulteta, 1972.
Pompe-Kirn V, Kovačič J, Primic-Žakelj M. Epidemiološka ocena zgodnjega odkrivanja RMV v Sloveniji v letih 1977–1986. Zdrav Vestn 1991; 60: 347–50.
Pompe-Kirn V, Zakotnik B, Volk N, Benulič T, Škrk J. Preživetje bolnikov z rakom v Sloveniji 1963–1990. Ljubljana: Onkološki inštitut, 1995.
Primic-Žakelj M, Projektna skupina ZORA. Odzivnost in nekatere značilnosti žensk, ki so prišle na ginekološki pregled v projektu ZORA. In: Kralj B, Denona V eds. 2. kongres ginekologov in porodničarjev Slovenije z mednarodno udeležbo, Portorož 2000. Ljubljana: Združenje ginekologov in porodničarjev Slovenije 2000, 147–9.
Primic Žakelj M. Priporočila o presejanju za raka v Evropski uniji. In: Lindtner J, Štabuc B, Bešić N, Budihna M, Frković Grazio S, Marolt F, Matos E, Novaković S, Škrk J, Zakotnik B, Žgajnar J eds. Družinski zdravnik in rak. 15. onkološki vikend, Ljubljana 2000. Zbornik. Ljubljana: Kancerološko združenje Slovenskega zdravniškega društva; Zveza slovenskih društev za boj proti raku, 2000: 21–9.
Primic-Žakelj M, Uršič-Vrščaj M. ZORA: državni program zgodnjega odkrivanja predrakavih sprememb materničnega vratu. Onkologija 1997, 1: 51–3.
Primic-Žakelj M et al. Poročilo o dosedanjem poteku projekta ZORA. Onkologija 1999; 3(2): 82–6.
Coleman D, Day N, Douglas D et al. European guideliness for quality assurance in cervical cancer screening. Eur J Cancer 1993; 29A: Suppl 4: S1–S38.
Franco E, Monsonego J eds. New developments in cervical cancer screening and prevention. Oxford: Blackwell Science Ltd, 1997.
Ponten J, Adami HO, Bergstrom R et al. Strategies for global control of cervical cancer. Int J Cancer 1995; 60: 1–16.
Navodilo o spremembah in dopolnitvah navodila za izvajanje preventivnega zdravstvenega varstva na primarni ravni. Uradni list RS, 2002; 11: 3122–9.
Linos A, Riza E. Comparison of cervical screening programmes in the European Union. Eur J Cancer 2000; 36: 2260–5.
Jerman P. Obračunski sistem v ambulantni ginekologiji. ISIS 2001; 3; 29–31.
Rakar S, Možina A, Eržen M. Vzroki ustaljene incidence RMV v Sloveniji, Raziskovalna naloga. Ljubljana: MZT, 2000.
Možina A. Analiza zdravljena prekanceroz, Ginekološka klinika, strokovno poročilo 2000. Ljubljana: Ginekološka klinika, 2002.
Relative risk of development cervical cancer. Institute for Clinical Systems Improvement, 2001.
Možina A. Zgodnja detekcija raka materničnega vratu. Kolposkopski tečaj. Zbornik predavanj. Ljubljana: Ginekološka klinika, 2002.
Schifman M. Screening for cervical cancer. ASCCP, Biennal meeting. Kraj: ASCCP, 2002.
Nieminen P et al. Organised vs spontaneous PAP smear screening for cervical cancer: A case control study. Int J Cancer 1999; 83: 55–8.
Pinter B, Tomori M. Sexual behaviour of secondary-school students in Slovenia. Eur J Contracept Reprod Health Care 2000; 5: 71–6.
Smrkolj Š. Ali obstoja hitro rastoči rak materničnega vratu. Magistrsko delo. Ljubljana: Medicinska fakulteta, 2001.
Vlada RS, Ministrstvo za zdravje. Imenovanje programskga sveta DP ZORA in njegove naloge. Sklep 510-4-2002-2. Ljubljana: Ministrstvo za zdravje, 2002.
Uršič Vrščaj M, Rakar S, Kovačič J, Kralj B, Možina A. Priporočila za odkrivanje, zdravljenje in nadzor bolnic s predrakavimi spremembami materničnega vratu. Ljubljana: Zdravniška zbornica Slovenije, 2000.
Pogačnik A et al. Navodila za poenotenje izvidov brisov materničnega vratu in informacijskega sistema ginekološke citopatologije. Ljubljana: Zdravniška zbornica, 2002.
Onkološka ginekologija, Zbornik predavanj. Ljubljana: Ginekološka klinika, 2002.
Anon. Training of cytotechnologists and cytopathologists in cervical cancer screening in the 21st century: new approaches to vocational training and continuing professional education. Book of proceedings. Ljubljana 2003
Lomšek M. Analiza zdravljenja prekanceroz MV na Ginekološki kliniki v Ljubljani od 1996–2000. Specialistično delo. Ljubljana: Ginekološka klinika, 2003.
Standards and quality in colposcopy. NHS Cervical Cancer Sreening Publications, 1996.
Guidance notes on the safe use of diathermy loop exscision for the treatment of cervical intraepithelial neoplasia. NHS Cervical Cancer Screening Publications, 1997.
Kitchener H. Quality standards in colposcopy and cervical pathology. Training in colposcopy. Management of abnormal smears. State of the art. 4th International Multidisciplinary Congress. Pariz: 2000.
Walker P. Counseling of patients reffered for colposcopy. Management of abnormal smears. State of the art. 4th International Multidisciplinary Congress. Pariz: 2000.
The role of genito urinary medicine cytology and colposcopy in cervical screening. NHS Cervical Cancer Sreening Publications, 1994.
NCN workshop on information and colposcopy. NHS Cervical Cancer Sreening Publications, 1996.
Ferenzy A. Viral testing for genital human papillomavirus infections: Recent progress and clinical potentials. Int J Gynecol Cancer, 1995; 5: 321–8.
Human papillomavirus and cervical cancer: New concepts and challenges. In: Monsonego J ed. Book of Proceedings. EUROGIN 2000 Congres. Paris: Monduzzi Editions, 2000.
Richart RM, Schiffman M, Cox JT et al. Using HPV tests to manage patients with abnormal PAP smears. Contemporary OB/GYN, 1995; 40(8): 5–88.
Monsonego J, Franco E eds. Cervical cancer control. General statements and guidelines. EUROGIN-WHO International Joint Meeting. Paris: UNESCO, 1997.
Arnold K. Guidelines for abnormal PAP tests: Do physicians follow them? JNCI 2002; 94: 880–1.
Mandelblatt JS, Lawrence WF, Womak SM et al. Benefits and costs of using HPV testing to screen for cervical cancer. JAMA 2002; 287: 2372–81.
Kim JJ, Wright TC, Goldie SJ. Cost-effectiveness of alternative triage strategies for atypical squamous cells of undetermined significance. JAMA 2002; 287: 2382–90.
Manos M et al. Utility of HPV DNA testing and liquid-based cytology in the triage of women with mild pap abnormalities. JAMA 1999; 281: 1605–10.
Monsonego J. Global challenges of cervical cancer prevention. Eur J Gynaec Oncol 2000; 6: 533–41.
Solomon D, Davey D, Kurman R et al. The 2001 Bethesda system. Terminology for reporting results of cervical cytology. JAMA 2002; 287: 2114– 20.
Wright TC, Cox JT, Massad LS et al. 2001 Consensus guidelines for the management of women with cervical cytological abnormalities. JAMA 2002; 287: 2120–9.
Uršič-Vrščaj M. Pomen HPV 16 in 18 pri odkrivanju zgodnjega raka materničnega vratu. Disertacija. Ljubljana; Medicinska fakulteta, 1995.
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