Performance Indicators of Cervical Cancer Screening Program Based on The Guidelines of Iran Ministry of Health and Medical Education

Abstract

Background: Systematic application of a cervical cancer screening program reduces the socioeconomic burden of the disease. Evaluation of screening programs using performance indicator sets and applying cultural, economic, and social considerations minimize the negative impacts of screening and maximize its benefits. Objectives: The present study aimed at developing and evaluating performance indicators of a cervical cancer screening program based on the guidelines of Iran Ministry of Health and Medical Education to identify shortcomings and improve national programs. Methods: A total of 839 out of 2504 care checklists for middle-aged women in Rasht, Iran, from 2014 to 2018 were studied. Indicators were evaluated based on the guidelines of Iran Ministry of Health and Medical Education on care for middle-aged individuals in 6 areas of screening intensity, screening the program performance, the participation of individuals, compliance of the implementation with guidelines, etc. Results: The eligible women coverage index was 34%. The index of participation in the first run Pap test was 45.53% in 2014. The study findings showed that with the implementation of the plan on participants, the test rate increased by 39.1%. The indices of identification of high-risk individuals based on medical histories, identification of abnormal Pap smears, and participation continuity in the program were 54.84, 33.73%, respectively and 1.32% in 2015, which decreased to < 1% in 2016. The compliance rate with the guidelines was 64.94%, and the performance recording index was 22.40%. Conclusions: Due to the low coverage rate and other performance indicators, especially the low continuity index, the attention of policy-makers and program managers should be drawn to potential shortcomings of screening programs, such as active implementation, in order to promote women’s health status.