Cervical Cancer Screening

Part 1: Introduction

Part 2: Characteristics for Success: Cervical Cancer Screening

Part 3: Implementation of Clinical Quality Measure: Cervical Cancer Screening

Part 4: Improvement Strategies: Cervical Cancer Screening

Part 5: Holding the Gains and Spreading Improvement

Part 6: Supporting Information

To gain insight into how one QI team approached this measure, review a hypothetical case study highlighting a fictional health center, White Cloud Health Group, and its approach to improving Cervical Cancer Screening performance.

1. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999-2005 Incidence and Mortality Web-based Report. Atlanta (GA): Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute; 2009.
2. Shike M, Winawer SJ, Greenwald PH, et al.: Primary prevention of colorectal cancer. The WHO Collaborating Centre for the Prevention of Colorectal Cancer. Bull World Health Organ 68 (3): 377-85, 1990.
3. Ries LAG, Eisner MP, Kosary CL, et al., eds.: SEER Cancer Statistics Review, 1975-2002. Bethesda, MD: National Cancer Institute, 2005.
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5. Krook JE, Moertel CG, Gunderson LL, et al.: Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med 324 (11): 709-15, 1991.
6. Colorado Colorectal Cancer Screening program fact sheet. November 2009;
7. Seifeldin R, Hantsch JJ. The economic burden associated with colon cancer in the United States. Clinical Therapeutics. 1999;21(8): 1370-1379.
8. Selby JV, Friedman GD, Quesenberry CP Jr., Weiss NS. A case control study of screening sigmoidoscopy and mortality from colorectal cancer. New England Journal of Medicine 1992;326(10):653-657.
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10. Seeff LC, Nadel MR, Klabunde CN, Thompson T, Shapiro JA, Vernon SW, et al. Patterns and predictors of colorectal cancer test use in the adult U.S. population. Cancer 2004;100: 2093-103.
11. Patterns of colorectal cancer screening uptake among men and women in the United States. Mesissner HI; Breen N; Klabunde CN; Vernon SW, Cancer Epidemiol Biomarkers Prev. 2006 Feb; 15 (2): 389-94
12. Best practices and lessons learned: status in HRSA HDC 2006; Ahmed Calvo, MD
13. Healthy People 2010 progress report
14. CDC Colorectal Cancer Rates by Race and Ethnicity
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16. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. Meissner HI; Breen N; Klabunde CN; Vernon SW; Cancer Epidemiol Biomarkers Prev. 2006 Feb;15(2):389-94
17. Institute of Medicine. Breakthrough Series College Aim Statement Checklist Boston: Institute for Healthcare Improvement. February 2004.
18. Adapted from pre-work manual used in HRSA sponsored Health Disparities Collaborative
19. NQC "A Guide to Consumer Involvement"
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21. Rex, DK, Johnson, DA, Anderson, JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol 2009; 104: 739
22. Levin, B, Lieberman, DA, McFarland, B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008; 58: 130.
23. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008; 149:627
24. Low rates of colorectal, cervical, and breast cancer screening in Asian Americans compared with non-Hispanic whites: Cultural influences or access to care? Kandula NR; Wen M; Jacobs EA; Lauderdale DS Cancer. 2006 Jul 1;107(1):184-92.
25. Adapted from Chronic Care Model...
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1. American Cancer Society. What are the risk factors for colorectal cancer?
2. The Annual Report to the Nation on the Status of Cancer, 1973-1997, with a special section on colorectal cancer (Cancer)
3. Cancer Intervention Surveillance Network (CISNET), Colorectal Cancer Mortality Projections
4. Colorectal Cancer (PDQ®): Screening - Health Professionals
5. Colorectal Cancer Testing in the Medicare Population: 1998-2004
6. Healthy People 2010, Volume 1, Chapter 3 - Cancer
7. National Cancer Institute, Colorectal Cancer Screening: Questions and Answers
8. National Health Interview Survey (NHIS) (NCHS)
9. State Cancer Profiles, Latest Rates, Percents, and Counts
10. U.S. Preventive Services Task Force Recommendations (ARHQ)
11. Rex, DK, Johnson, DA, Anderson, JC, et al. American College of Gastroenterology guidelines for colorectal cancer screening, 2008. Am J Gastroenterol 2009; 104: 739
12. Levin, B, Lieberman, DA, McFarland, B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008; 58: 130.
13. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008; 149:627