Cervical cancer prevention indicators selected by the POWER technical expert panel: Full cohort definition is described in text. Data sources for each indicator are shown in parentheses.
| Indicator | Numerator | Denominator | Rationale |
|---|---|---|---|
| Screening-eligible women who have had at least 1 Papanicolaou test in the past 3 years | Women aged 18 to 70 years who had not undergone hysterectomy, and who had 1 or more Pap tests in the past 3 years (RPDB, OHIP, OCR, DAD, CytoBase) | Full cohort of women eligible for Pap tests | The most conservative of the cervical cancer prevention guidelines recommend that each eligible patient be screened at least once every 3 years |
| Women whose Pap test results indicate ASC-US with a high-risk HPV type and who have a follow-up colposcopy within 6 months of the abnormality being identified | No. of women who have a follow-up colposcopy within 6 months of abnormality (RPDB, OHIP, OCR, DAD, CytoBase) | No. of women diagnosed with an initial abnormal Pap test result of ASC-US with high-risk HPV | Women with a high-risk HPV type are destined to develop high-grade disease and cancer if they are not assessed and treated for high-grade dysplasia |
| Follow-up of women with low-grade lesions | No. of women who have a follow-up colposcopy or Pap test within 6 months of an ASC-US or LSIL abnormality (RPDB, OHIP, OCR, DAD, CytoBase) | No. of women diagnosed with an ASC-US or LSIL Pap test result | Women with these abnormalities require follow-up by Pap test or colposcopy to determine if the abnormal findings resolve or progress |
| Follow-up of unsatisfactory Pap test results | Women with unsatisfactory Pap test results who are retested within 4 months (RPDB, OHIP, OCR, DAD, CytoBase) | No. of women diagnosed with unsatisfactory Pap test results | Unsatisfactory means that either for anatomic reasons or based on the presence of dysplasia or cancer, the Pap result is not satisfactory. These women require repeat testing |
ASC-US—atypical squamous cells of uncertain significance, DAD—Discharge Abstract Database, HPV—human papillomavirus, LSIL—low-grade squamous intraepithelial lesion, OCR—Ontario Cancer Registry, OHIP—Ontario Health Insurance Plan, POWER—Project for an Ontario Women’s Health Evidence-Based Report, RPDB—Registered Persons Database.