Cervical Cancer Screening (20-29)
- 1 Basic Facts
- 2 Brief overview of the measure
- 3 Application and interpretation of the measure
- 4 Calculation of the measure
- 5 Appraisal of the measure
- 6 Other items
- 7 Owner detail
Stage of development
Potential or current usage
This measure has been part of the PHO Performance Programme's National Indicator Set since 1 January 2011 and is used to measure how many women aged 20 to 69 years have had a cervical smear within the last 3 years.
Brief overview of the measure
This measure focuses on the number of women aged between 20 and 69 years who have had a cervical screen within the last 3 years.
Rationale for selection
Early detection and treatment of cervical cancer and other abnormalities lowers the rate of death from cervical cancer. The national cervical screening programme recommends women have three yearly cervical screens from the ages 20 to 69 years. This screening interval may alter if a smear result is abnormal.
Domain(s) of quality
Application and interpretation of the measure
Stated intent of the measure
Ensuring appropriate follow up of patients that are eligible for a cervical screen.
Caveats - Considerations
This measure, when reported through the PHO Performance Programme has had a hysterectomy algorithm applied - the algorithm has been developed by the National Screening Unit based on the number of hysterectomies provided from 1987 through to 1992 by age. The algorithm is as follows: Age Group Adjustment Factor (multiplied by women in age group) 20 - 24 years 1 25 - 29 years .996 30 - 34 years .980 35 - 39 years .944 40 - 44 years .886 45 - 49 years .819 50 - 54 years .769 55 - 59 years .743 60 - 64 years .726 65 - 69 years .708
Level of health care delivery/setting
This measure is currently reported by the PHO Performance Programme to PHO level although use of this measure to monitor practice and patient level performance is also possible.
All women aged 20 to 69 years All women aged 20 to 69 years within the high need population (identified as Māori, Pacific Island and/or Decile 9 or 10)
Stratification by vulnerable populations
The PHO Performance Programme currently uses this measure to monitor at both a total PHO enrolled population level (all PHO enrolled eligible patients) and a high need PHO enrolled population level (whereby high need is identified as Māori, Pacific Island and/or Decile 9 or 10)
This measure is currently funded through the PHO Performance Programme both at a total population level and a high need level.
Calculation of the measure
Output of calculation
Percentage of women aged 20 to 69 years who have had a cervical screen in the past 3 years.
The number of women enrolled with a PHO aged 20 to 69 years who have had a cervical screen in the past 3 years.
The number of women enrolled with a PHO aged 20 to 69 years (adjusted for the expected number of women who have had a hysterectomy).
Criteria/standard for optimal performance
Every practice within a PHO should have a process in place for identifying / recalling women that are due for a cervical screen and following through to ensure the service has taken place. The PHO Performance Programme goal is: 75% or more of the PHO’s target population have had a cervical screen within 3 years.
PHO patient enrolment registers and the National Screening Unit's cervical screening register.
Method of extraction
The link below will take you to the document that defines how the measure is calculated - see 'Cervical Cancer Screening Coverage' section of the Indicator Definitions for PHOs document. http://www.dhbnz.org.nz/Site/SIG/pho/Operational-Documents.aspx
Key issues and challenges for data management
Many women who have had a hysterectomy do not need a cervical smear. The Programme does apply an adjustment calculation to allow for women with hysterectomies, based on the national rate. However since the rate of hysterectomies within each PHO may vary, this adjustment may not always be correct at the PHO level. Some patients choose to ‘opt off’ the national screening programme’s register (which means that although they have had a cervical screen, they will not be ‘counted’ by the Programme).
Appraisal of the measure
Initial selection of this indicator in 2005 was done by the Ministry of Healh using a consensus process. Since then the indicator has been reviewed and refined in consultation with the PHO Performance Programme Advisory Group - refer to link for current membership list: http://www.dhbnz.org.nz/Site/SIG/pho/PHO/Membership-List.aspx All changes have been endorsed by the PHO Performance Programme Governance Group - refer to link for current membership list: http://www.dhbnz.org.nz/Site/SIG/pho/PHO/Governance-Group-Membership-List.aspx
Date of entry to library
Owner (Organisation name)
PHO Performance Programme
Owner (Email contact)
Creator (Organisation name)
PHO Performance Programme
Creator (Email contact)