Review of the cervical cancer screening programme in the Puttalam district

Abstract

INTRODUCTION & OBJECTIVES: A well implemented screening programme is effective in preventing cervical cancer. ln order to improve programme effectiveness all programmes need to be reviewed periodically. The objective of this study was to review the cervical cancer screening program in Puttalam District. METHODS: Cross sectional descriptive study was done in 2015. Primary and secondary data was collected using data collection sheets, self-administered questionnaires and structured interviews from all stake holders involved in cervical cancer screening program in Puttalam District. RESULTS: Adequate number of clinics were available considering clinic to population ratio of 1: 15000 as the norm, but vacant positions existed in all staff categories. Colposcopes were unavailable and zero stock episodes of consumables were noted at MOH level. Target age group (35 years) Pap smear coverage, number of cervical visualizations, pap smears taken and positive pap smears were indicators used to monitor the programme. Positive cervical cytology reporting time was more than 10 weeks (mean was 72 days, range 2-334). Guidelines relating to quality control; obtaining a pap smear & cytology process and documentation regarding process of follow up care were not available. Coverage of target age group women (35 years) increased from 28.4% (2013) to 32.4 % (2015). Number of cervical cancers prevented could not be calculated as follow-up information was not available. CONCLUSION: Human resources and equipment relating to pap smear screening need improvement. Indicators sensitive to target population; cytology report turn-around time, and quality indicators need to be built in to program, guidelines developed and evaluated. Outcome of screened positives should be followed up and documented.