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Recipe Name:

Cervical Cancer Screening Participation Rate

Rationale:

The ‘cervical cancer participation rate’ recipe will support practices who are participating in cervical cancer screening quality improvement to establish and monitor the cervical cancer screening participation rate in their practice.

  • Cervical cancer is one of the most preventable cancers
  • Almost 80% of cervical cancers occur in women who have never been screened or are not up-to-date with their cervical screening[i]

Establishing and monitoring their bowel cancer screening participation rates allows primary care providers to:

  • assess the need within their service for undertaking activities to improve patient participation in cervical cancer screening

monitor the impact of cancer screening quality improvement activities on their cervical cancer screening participation rates


[i] Cancer Institute NSW: About cervical screening, 11/18 update. https://www.cancer.nsw.gov.au/cervical-screening-nsw/about-cervical-screening (cited: Jan 2019)

Target:

The proportion of active female patients aged between 25 and 74 years of age who have had a Pap test in the previous 2 years OR a Cervical Screening Test in the previous 5 years

Numerator: The number of active female patients aged between 25 and 74 years of age who have had a Pap test in the previous 2 years OR a Cervical Screening Test in the previous 5 years     

Denominator: The number of active female patients aged between 25 and 74 years of age who are eligible for the National Cervical Screening Program

Recipe Limitations:

This report excludes patients with a number of conditions, including hysterectomy, under the 'ineligible’ category.

Practices should be aware of the diagnosis codes that PEN uses to assign patients to ‘ineligible’. 

Practices should undertake periodic clinical review of patients in the ‘ineligible’ category to assess if any of these patients should return to screening.

Your practice may have patients that you consider clinically ineligible for screening that are not captured by these diagnosis codes.  These patients should be manually opted out of screening.

CAT Starting Point:

  1. CAT Open - CAT4 view (all reports) loaded
  2. Population Extract Loaded and Extract Pane “Hidden”
    1. Filter Pane open and under the ‘General’ tab ‘Active Patients’ (3x <2 years) selected

CAT4 starting point

 

RECIPE Steps Filters:

  • In the “General” Tab, click the 'Active' box and enter Start Age = 25 and End Age = 74

You can select the Gender/Female but the report will automatically show female patients as well as patients with no gender entered. This is the preferred approach, as it will include all patients potentially at risk including those without gender information entered.

Practices should review those patients for whom no gender is entered to ensure they are only sent appropriate cancer screening reminders.  Consideration should be given to keeping a register of transgender, gender diverse and intersex patients to support this process.


  • Click "Recalculate"
  • Click ‘Hide Filters’

 

Report Steps

  • Select the "Screening/Cervical Screening" tab
  • Tick the 'Show Percentage' box on the top left

This report will show the selected patients and the proportion of patients with a CST or Pap Smear recorded.


Using the report to establish your cervical cancer screening participation rate

Your cancer screening participation rate is the proportion of patients in the (HPV >5yrs or Pap >2yrs (no HPV) category. 

Using the example pie graph provided, the cervical cancer screening participation rate for this practice is 32.7%.

Updating your patient records through the National Cancer Screening Register

Because women sometimes prefer to go to someone other than their usual healthcare provider for their cervical screening test and because practices may not know the cervical screening history of new patients, patients can appear overdue for screening when they are not. 

This report can be exported to be sent to the National Cancer Screening Register (NCSR) for review, they will advise which patients have attended screening.  They will require the patient’s Medicare number which is included in the patient report. Follow the steps to export the patient list to Excel for details.

Call the NCSR on 1800 627 701 for more information.


To Export Patient List to Microsoft Excel:

1.  Click on the “Export Icon”  at the top of the Patient Reidentification window.

2.  Click on “Excel”

3.   Choose a file name and a location to save to (eg. Create a folder C:/ClinicalAudit/CAT Patient FollowUp)

4.  Click “Save”

 

The steps above will produce a list of patients with contact details in MS Excel which can then be used to:

  1. Produce a mail merge or bulk SMS to remind patients to attend cancer screening.
  2. Phone patients to update their record or to remind them to attend cancer screening.
  3. Go back through the individual patient records in the GP Clinical Desktop System (CDS) and update known records