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Journal of the National Cancer Institute Advance Access published online on April 29, 2008
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djn131
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© The Author 2008. Published by Oxford University Press.

EDITORIALS

Routine Audit of Large-Scale Cervical Cancer Screening Programs

Jack Cuzick

Affiliation of author: Cancer Research UK Centre for Epidemiology, Mathematics, and Statistics, Wolfson Institute of Preventive Medicine, London, UK

Correspondence to: Jack Cuzick, PhD, Cancer Research UK Centre for Epidemiology, Mathematics, and Statistics, Wolfson Institute of Preventive Medicine, Charterhouse Square, London EC1M 6BQ, UK (e-mail: jack.cuzick@cancer.org.uk).

The first 10% of the full text of this article appears below.

In this issue of the Journal, Andrae et al. (1) present the first audit of a national screening program for cervical cancer, and they should be congratulated for their efforts. In the United Kingdom, such audits were proposed in 1986 (2) and pilot audits were first reported in 1996 (3), but audits have yet to be translated into a routine national activity. Screening is a large-scale, repetitive "industrial process" and, as with all other such processes, one can learn most about its performance by examining the failures—here defined as a woman who is eligible for screening and who develops a potentially fatal cervical cancer—and then retuning the process accordingly.

To this end, the screening histories of women who developed cervical cancer can be compared with those of a population-based age-matched sample of women who were eligible for screening but did not develop cancer. . . . [Full Text of this Article]


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