Author/Editor     Rebolj, Matejka; Ivanuš, Urška; Lynge, Elsebeth
Title     Indicators of quality assurance in cancer screening - the case of cervical cancer
Type     članek
Source     Bilt Ekon Org Inf Zdrav
Vol. and No.     Letnik 26, št. 2
Publication year     2010
Volume     str. 44-51
Language     eng
Abstract     Cancer screening is a public health service targeting apparently healthy people aiming to identify individuals at higher risk for cancer, and to initiate treatment before the symptoms appear. Because it is a resource-intensive activity that can also induce much harm in the form of overdiagnosis, overtreatment and anxiety, it needs to be evaluated carefully and on an on-going basis. The basic indicators of screening effectiveness (mortality and incidence rates, rates of interval cancers, coverage and attendance rates, compliance with follow-up, detection rate of lesions), side effects (proportion of positive screening tests, morbidity associated with abnormal findings) and efficiency (numbers of screening tests and excess tests, positive predictive value) are presented in this paper. While their use and the necessary data sources are illustrated and discussed using cervical screening as an example, these indicators are applicable to evaluation of other types of cancer screening.
Summary     Presejalni programi za zgodnje odkrivanje raka so namenjeni pravočasni prepoznavi in zdravljenju navidezno zdravih posameznikov s predrakavimi ali začetnimi rakavimi spremembami, ki še ne povzročajo težav. Organizirani presejalni programi pomenijo za državo veliko investicijo, za vključene posameznike pa poleg koristi tudi nevarnost čezmerne diagnostike in zdravljenja ter nepotrebnega vznemirjanja. Zato je z etičnega in finančnega vidika te programe nujno redno spremljati in nadzorovati. V članku so predstavljeni osnovni kazalniki uspešnosti presejanja (stopnja incidence in umrljivosti, intervalni rak, pregledanost, odzivnost na vabilo, kontrolni pregledi po pozitivnem presejalnem testu, delež pozitivnih histoloških izvidov), neželenih stranskih učinkov (delež posameznikov s pozitivnim presejalnim testom, prisotnost simptomov ali znakov ob pozitivnem presejalnem testu) ter učinkovitosti presejanja (število presejalnih in čezmernih testov, pozitivna napovedna vrednost). Čeprav so kazalniki kakovosti in potrebni viri podatkov opisani v kontekstu presejalnega programa za zgodnje odkrivanje raka materničnega vratu, je z njimi možno spremljati in nadzorovati tudi druge presejalne programe.
Descriptors     MASS SCREENING
QUALITY ASSURANCE, HEALTH CARE