1、1,Cervical Screening Programme(CSP),November 2006,2,Cervical Cancer in Hong Kong,Incidence rateThe 4th most common cancer among females in Hong Kong in 2003408 new cases, accounting for 4.3% of all new cancer cases in femalesAge-specific incidence rate: 8.9/100,000Median age at diagnosis: 50 years,3
2、,Cervical Cancer in Hong Kong,Mortality rate8th most common cause of cancer deaths among females in 2004128 deathsAccount for 2.8% of all cancer deaths in females,4,International Comparison of Age-standardized Incidence and Mortality Rates of Cervical Cancer,5,Local Situation Before the Launching of
3、 CSP,Lack of an organized screening programmeCervical smear taking coverage rate among women was about 44%Screening was not based on womens risks or needsMany women had little knowledge or had misconceptions on cervical screeningLack of well recognized quality management guidelines and standardsNo c
4、entral registry to store the cervical smear resultsPublic and private sector service providers operated separately without collaboration,6,The Development of CSP,In 2001 Policy Address, the Government pledged to launch a Cervical Screening Programme (CSP) for womenThe Cervical Screening Task Force (
5、CSTF) was established in December 2001 to oversee the planning, implementation and evaluation of CSP,7,The Development of CSP,Public health experts,Membersof CSTF,Professional groups,Women groups,Universities,NGOs,Service providersFrom public & privatesectors,3 Working Groups formed,Recruitment & Ed
6、ucation,Quality Management,Information System,8,The Development of CSP,The goals of CSTFTo formulate a sound, evidence-based screening policy for maximize the benefits of the programmeTo develop effective recruitment and public education strategiesTo build an information system, the Cervical Screeni
7、ng Information System (CSIS)To establish quality assurance standards and guidelinesTo facilitate public-private collaboration,9,The Development of CSP,Department of Health (DH) conducted questionnaire surveys on private practitioners and laboratories:To collect information on cervical screening prac
8、tices and difficulties facedTo collect their opinions on cervical screening programmeDH also visited various private laboratories and clinicsTo understand their modes of operation and information systems,10,The Development of CSP,DH conducted focus group study on women:of different ages and backgrou
9、ndto study their beliefs, behaviour and attitudes regarding cervical screeningto investigate the facilitators and barriers for women to receive cervical smear examination,11,The Development of CSP,In July 2003, the Health Panel of the Legislative Council supported the CSP.CSP was launched on 8 March
10、 2004 by DH in collaboration with other health care providers,12,13,14,Screening Policy Target Population,Women aged from 25 to 64 yearsIf 2 annual cervical smear results are normal take smear every 3 years thereafterWomen aged 65 years or aboveIf previous 3 consecutive smear results are normal no n
11、eed for further smearsWomen aged below 25 yearsFor those who have high risk profile for cervical cancer may be screened according to professional judgement,15,Screening Policy Screening Interval,In most circumstances, screening frequency should be annually for initial 2 years, and if the results are
12、 both normal, then 3-yearly thereafterWomen with risk factors for cervical cancer may need to be screened more frequently,16,CSP Flow Diagram,DH conducts publicity programmes to raise public awareness,Women select and pay service providers tohave cervical smears,The central registry sends reminder l
13、etters to womendue for next screening and provides information to service providers for follow-up,Women and service providers cooperatewith DH in providing informationto the central registry,17,Recruitment and Education Strategies,Publicity activities to the general public:Sending invitation letters
14、 to householdsOrganizing publicity activities: advertisements on TV, radio, major transportation networks, newspapers and magazines; roving exhibitions and health talksDistribution of education and publicity materials, e.g. booklets, VCDs, tapes and posters, etc.Established a 24-hour education hotli
15、ne and CSP hotlineEstablished the CSP website,18,19,20,21,22,23,24,25,26,27,28,Recruitment and Education Strategies,Publicity activities to service providers and laboratories:Organized briefing sessionsIssued invitation letters to service providersPlaced advertisements in medical journalsDistributio
16、n of materials during medical seminars and talksCollaborated with professional groupsOrganized sharing sessions for laboratory workers,29,30,Cervical Screening Information System (CSIS),The central registry of the CSPRegister personal informationMaintain information on screening history and resultsT
17、rack utilization of cervical screening service and follow-up eventsIdentify women due for screening and send them remindersFacilitate record linkage across service providersGenerate statistics on coverage rates and quality assurance standardsAid research and evaluation,31,Quality Management,Quality
18、management guidelines have been drawn up for all stages of the cervical screening pathway:Proper smear taking proceduresProper cytological diagnosis by the laboratoryCervical smear reportsManagement of abnormal smear resultsAppropriate follow-up and treatment of abnormal conditions,32,Quality Manage
19、ment,CSP specifically produced the Cervical Screening Manual, the contents of which include proper smear taking procedures and handling of the specimens, and also the management guidelines of abnormal smears issued by the Hong Kong College of Obstetricians and GynaecologistsProvide training for heal
20、th professionals who work in the Maternal & Child Health Centres,33,Collaboration of the Public and Private Sectors,CSTF members come from both public and private sectorsFree distribution of professional training kits to private service providersCSIS collect and store smear records to facilitate pat
21、ient care by private doctors Work with universities and professional groups to organize refresher courses,34,35,Benefits of CSP to Women,Women will receive reminder letters when their next test date is dueWomen can view their own cervical smear results in CSISWith womens consent, registered service
22、providers can retrieve their cervical smear records, so as to provide more appropriate follow-up,36,Benefits of CSP to Service Providers,Can retrieve smear records of registered women through the internet, so as to provide more appropriate follow-upWill receive a list of women whose smear is due or
23、overdue in order to facilitate arrangement for appointment Will receive CSP education and publicity materials free of chargeThe clinic information of the service providers will be uploaded onto the CSP website and printed in reminder letters, to facilitate women in making appointment for examination
24、,37,搜 尋 服 務 提 供 者 - 地 圖,38,39,Statistics,As of September 2006, the registration figures of CSP are:More than 220 000 women have registeredRegistered service providers: about 600Registered laboratories: 13,40,Statistics,According to DHs telephone survey in October 2005, about 61.6% women have ever had cervical smear,41,The success of CSP relies on the collaboration of every service provider and organization,42,The End,
