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Cervical Screening Programme

(CSP)

November 2006

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Cervical Cancer in Hong Kong Incidence rate

The 4th most common cancer among females in Hong Kong in 2003

408 new cases, accounting for 4.3% of all new cancer cases in females

Age-specific incidence rate: 8.9/100,000 Median age at diagnosis: 50 years

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Cervical Cancer in Hong Kong

Mortality rate 8th most common cause of cancer

deaths among females in 2004 128 deaths Account for 2.8% of all cancer deaths

in females

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International Comparison of Age-standardized Incidence and Mortality Rates

of Cervical Cancer Age-standardized incidence rates

14.2

9.7

9.5

9.4

9.4

9.3

9.2

8.1

7.5

7.0

6.7

6.5

6.4

6.3

3.8

0 4 8 12 16

Singapore (1993-1997)

Hong Kong (2000)

Ireland (1998)

Germany (1998)

US(SEER) - Black (1996-2000)

Norway (2000)

New Zealand (1999)

European Union (1998)

England (1999)

Sweden (2000)

Canada (1999)

The Netherlands (1998)

US(SEER) - White (1996-2000)

Australia (1999)

Finland (1999)

Rates (per 100,000 standard population)

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Hong Kong (2000)

Age-standardized mortality rates

4.2

4.1

3.5

3.2

2.8

2.7

2.6

2.6

2.3

2.0

1.9

1.9

1.8

1.6

1.3

0 1 2 3 4 5

US - Black (1996-2000)

Singapore (1998)

Ireland (1998)

Norway (1997)

European Union (1998)

New Zealand (1999)

Hong Kong (2000)

Germany (1999)

England and Wales (2001)

US - White (1996-2000)

Sweden (2000)

Canada (1997)

The Netherlands (1999)

Australia (1999)

Finland (1999)

Rates (per 100,000 standard population)

Hong Kong (2000)

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Local Situation Before the Launching of CSP

Lack of an organized screening programme Cervical smear taking coverage rate among women

was about 44% Screening was not based on women’s risks or needs Many women had little knowledge or had

misconceptions on cervical screening Lack of well recognized quality management

guidelines and standards No central registry to store the cervical smear results Public and private sector service providers

operated separately without collaboration

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The Development of CSPIn 2001 Policy Address, the

Government pledged to launch a Cervical Screening Programme (CSP) for women

The Cervical Screening Task Force (CSTF) was established in December 2001 to oversee the planning, implementation and evaluation of CSP

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The Development of CSP

Public health experts

Membersof CSTF

Professional groups

Women groups

Universities

NGOs

Service providersFrom public

& privatesectors

3 Working Groups formed

Recruitment & Education

Quality Management

Information System

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The Development of CSPThe goals of CSTF

To formulate a sound, evidence-based screening policy for maximize the benefits of the programme

To develop effective recruitment and public education strategies

To build an information system, the Cervical Screening Information System (CSIS)

To establish quality assurance standards and guidelines

To facilitate public-private collaboration

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The Development of CSP Department of Health (DH) conducted questionnaire

surveys on private practitioners and laboratories: To collect information on cervical screening

practices and difficulties faced To collect their opinions on cervical screening

programme

DH also visited various private laboratories and clinics

To understand their modes of operation and information systems

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The Development of CSP

DH conducted focus group study on women: of different ages and background

to study their beliefs, behaviour and attitudes regarding cervical screening

to investigate the facilitators and barriers for women to receive cervical smear examination

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The Development of CSP

In July 2003, the Health Panel of the

Legislative Council supported the CSP.

CSP was launched on 8 March 2004 by

DH in collaboration with other health

care providers

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Dr. Lam Ping-yan, Director of Health delivering the opening speech at the launching ceremony

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The officiating party composed the CSP logo and declared the launching of the CSP. The officiating party (from left to right): Dr. Susan Fan, Mrs. Peggy Lam, Dr. Lam Ping-yan, Dr. Robert Law, Mrs. Leung Lau Yau-fan

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Screening Policy – Target Population

Women aged from 25 to 64 years If 2 annual cervical smear results are normal take smear ever

y 3 years thereafter

Women aged 65 years or above If previous 3 consecutive smear results are normal no need f

or further smears

Women aged below 25 years For those who have high risk profile for cervical cancer

may be screened according to professional judgement

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Screening Policy – Screening Interval

In most circumstances, screening frequency should be annually for initial 2 years, and if the results are both normal, then 3-yearly thereafter

Women with risk factors for cervical cancer may need to be screened more frequently

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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 letters to women

due for next screening and provides information to service providers for

follow-up

Women and service providers cooperate

with DH in providing informationto the central registry

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Recruitment and Education Strategies

Publicity activities to the general public: Sending invitation letters to households Organizing publicity activities: advertisements on T

V, radio, major transportation networks, newspapers and magazines; roving exhibitions and health talks

Distribution of education and publicity materials, e.g. booklets, VCDs, tapes and posters, etc.

Established a 24-hour education hotline and CSP hotline

Established the CSP website

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Recruitment and Education Strategies Publicity activities to service providers and

laboratories: Organized briefing sessions Issued invitation letters to service providers Placed advertisements in medical journals Distribution of materials during medical seminars

and talks Collaborated with professional groups Organized sharing sessions for laboratory

workers

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Cervical Screening Information System (CSIS)

The central registry of the CSP Register personal information

Maintain information on screening history and results

Track utilization of cervical screening service and follow-up events

Identify women due for screening and send them reminders

Facilitate record linkage across service providers

Generate statistics on coverage rates and quality assurance standards

Aid research and evaluation

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Quality Management Quality management guidelines have been

drawn up for all stages of the cervical screening pathway: Proper smear taking procedures Proper cytological diagnosis by the laboratory Cervical smear reports Management of abnormal smear results Appropriate follow-up and treatment of

abnormal conditions

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Quality Management

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 Gynaecologists

Provide training for health professionals who work in the Maternal & Child Health Centres

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Collaboration of the Public and Private Sectors

CSTF members come from both public and private sectors

Free distribution of professional training kits to private service providers

CSIS collect and store smear records to facilitate patient care by private doctors

Work with universities and professional groups to organize refresher courses

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Benefits of CSP to Women Women will receive reminder letters when their

next test date is due Women can view their own cervical smear

results in CSIS With women’s consent, registered service

providers can retrieve their cervical smear records, so as to provide more appropriate follow-up

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Benefits of CSP to Service Providers Can retrieve smear records of registered women through

the internet, so as to provide more appropriate follow-up

Will receive a list of women whose smear is due or overdue

in order to facilitate arrangement for appointment

Will receive CSP education and publicity materials free of

charge

The 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

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搜 尋 服 務 提 供 者 - 地 圖

   以 地 區 列 出    以 名 稱 列 出

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請 選 擇請 選 擇請 選 擇

搜 尋 服 務 提 供 者 - 條 件

區 域 :

地 區 :

機 構 :

名 稱 :

電 話 :

地 址 :

                         

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Statistics

As of September 2006,

the registration figures of CSP are:

More than 220 000 women have registered

Registered service providers: about 600

Registered laboratories: 13

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Statistics According to DH’s telephone survey in

October 2005, about 61.6% women

have ever had cervical smear

Ever had cervical smear 61.6%

The last smear was taken within 3 years

55.2%

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The success of CSP relies on

the collaboration of every service provider and organization

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The End