Recipe Name:

Patients eligible for cervical screening aged 25 years and 4 months or older with no recorded Pap/CST or who are 4 months or more overdue for a CST

Rationale:

Cervical cancer is one of the most preventable cancers.[1]  Over 90% of cervical cancer occurs in women who have either never been screened or who are lapsed screeners.[2]

This recipe supports practices to identify women who have not responded to invitations to screen from the National Cervical Screening Program so that the practice can reinforce to the patient the importance of cervical screening.

The recipe identifies women who are four months or more overdue for screening, allowing a three month period for women to respond to screening invitations or reminders.

[1] Cancer Institute NSW 2019. Cervical screening. https://www.cancer.nsw.gov.au/how-we-help/screening-and-early-detection/cervical-screening (Accessed August 2019)

[2] AIHW 2018b. Analysis of cancer outcomes and screening behaviour for national cancer

screening programs in Australia. Cancer series no. 111. Cat. no. CAN 115. Canberra: AIHW.

Target:

The female patients aged 25 years and four months or older, with no recorded PAP/CST who are at least 4 months overdue for a CST

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
    2. OPTIONAL under the ‘General’ tab ‘Active Patients’ (3x <2 years) selected

CAT4 starting point



RECIPE Steps Filters:

  • In the “General” Tab, select the 'Mths' radio button and enter Start Age = 304 and End Age = 888 months.

Practices should decide if they want to send screening reminders to active patients only.  Population based screening programs target asymptomatic patients.  You may have some patients who consider your practice their medical home who do not fit the criteria for being an ‘active’ patient. If required, select 'Active' to search for your active patients only



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

This report will show the selected patients and the patients without a CST or Pap Smear recorded or with their last test at least 5 years (CST) or 2 years (Pap) old. Select the following categories from the graph:

  • HPV>5yrs / Pap>2yrs (no HPV) - No HPV test in more than 5 years/ no Pap test in more than 2 years
  • Not Recorded



  • To see the list of eligible patients, click the 'Export' button after selecting the categories listed above. The list of patients can then be sorted by the Cervical Screening Date by clicking on the up/down triangle above the column to find those overdue by at least four months:



The report can also be exported to be sent to the national cancer register for bulk enquiries on patients cervical screening status.


To Export Patient List to Microsoft Excel:

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



2.  Click on “XLSX”

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

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


Optional Steps

There are a number of optional steps you can add. In the interest of keeping these recipes short, the optional steps are available in separate guides. You can combine the steps above with one, two or all three of the optional steps depending on your target group of patients.

Using Topbar Prompts in Recipes - create reminders for your clinicians based on the recipe searches

Using Recall CAT in Recipes - SMS and Voicemail directly from CAT4

Combine Screening Searches with MBS item eligibility - recall patients who are also eligible for MBS items related to chronic disease care or prevention