Indicator
Definition
Cervical Cancer Screening Participation Rate
Full data definition sign-off complete.
Name of Measure
Name of Measure (short)
Definition
Domain
Dimension
Type of Measure
Business Context
Rationale
Percentage of women 21-69 who have a Pap test in the last three years
Cervical Cancer Screening Participation Rate
Screening rates for cervical cancer for eligible women aged 21–69 years in a three-year
period
Health Services Delivery
Appropriateness
Process Measure
AHS Quality & Patient Safety Dashboard
The Quality and Patient Safety Committee of the Board requested the development of a
Quality and Patient Safety Dashboard to enable the monitoring of the quality of services
provided by Alberta Health Services (AHS).
According to the Guideline for Screening for Cervical Cancer:
“More than 45 types of human papillomavirus (HPV) are transmitted by intimate sexual
contact, and persistent infection with a carcinogenic type is necessary for cervical cancer to
develop. HPV is transmitted so easily that the lifetime cumulative prevalence of high-risk
infection approaches 80%. Most of these infections resolve without symptoms and without
treatment. A woman’s immune system generally clears the virus, in which case any cervical
cell changes the HPV infection may have caused resolve on their own. When the virus is not
cleared, persistent carcinogenic HPV infection may cause precancerous tissue changes that
can, over many years, progress to invasive cervical cancer. Early detection and treatment
during this lengthy precancerous stage can prevent the vast majority of cervical cancer.
Failure to be screened and being under-screened continue to be major risk factors for
cervical cancer in Alberta.”
Notes for Interpretation
AHS Targets:
2010 – 70% of women in target age group are screened every three years.
2015 – 75% of women in target age group are screened every three years.
2020 – 80% of women in target age group are screened every three years.
Women who are not eligible for Pap tests due to hysterectomy are not currently removed
from the denominator. This leads to an underestimate in the screening participation rate.
The time period for the metric is based on a calendar year.
Organizational Strategy

Actively engage women, families, and primary care providers as partners in system
improvements.

Focus on reducing disparities in uptake, and continue to develop and implement
community action plans and social marketing approaches.
Strategies to increase adoption of provincial screening guidelines in clinical practice
and physician workforce

December 20, 2012
Page 1 of 4
Indicator
Definition
Cervical Cancer Screening Participation Rate (continued)
Benchmark Comparisons
Cited
References:
December 20, 2012
National or International comparisons available:
Canada: 3 - year participation rate: 67% - 74%
Australia: 3 - year participation rate: 74%
Canada: http://www.phac-aspc.gc.ca/publicat/ccsic-dccuac/index-eng.php
Australia: http://www.health.gov.au/internet/screening/publishing.nsf/Content/facts
United Kingdom: http://www.cancerscreening.nhs.uk/cervical/publications/2008review.html
Guidelines for Screening for Cervical Cancer, Toward Optimized Practice (TOP), 2009. see
http://www.topalbertadoctors.org/cpgs.php?sid=2&cpg_cats=15 for details.
Page 2 of 4
Indicator
Definition
Cervical Cancer Screening Participation Rate (continued)
Technical Specifications
Metric
Preferred Display Format
Numerator
Inclusion Criteria for
Numerator
Exclusion Criteria for
Numerator
Data Source(s) for
Numerator
Refresh Rate of
Numerator
Denominator
Number of eligible women aged 21-69 screened at least once (per 3 year period)
Female, aged 21-69 at time of service, lives in Alberta at time of service, Pap test (s) is
performed within the 3-year reporting period
None
Alberta Health Fee-for-Service (FFS) data
The Alberta Cervical Cancer Screening Program (ACCSP) database will become the
primary data sources once it is established
Alberta Health FFS data is available for reporting annually
Once the ACCSP database becomes the primary data sources, data will be updated in realtime.
Number of women aged 21–69 years at year two of the three-year reporting period
Inclusion Criteria for
Denominator
Exclusion Criteria for
Denominator
Data Source(s)
for Denominator
Number of women aged 21-69 years at year two
Refresh Rate of
Denominator
Population estimates are estimated as of mid-year (June 30 each year) by Alberta Health
using Alberta Health Care Insurance Plan Stakeholder Registry.
Technical Notes
Calculation
Relationship to
Other Indicators
Level of Reporting
Frequency of Reporting
Limitations
December 20, 2012
Percentage calculation based on individual woman: individual is counted as one unit even
though one woman can have multiple Pap tests within the 3-year reporting period.
Rates are displayed with one decimal point.
None
Alberta Health Care Insurance Plan Stakeholder Registry
Data are available annually in June for the preceding three years.
Number of women (age 21-69) with at least one Pap test in a three-year period X 100
----------------------------------------------------------------------------------------------------Number of women in the target population (age 21-69) at year two of the three-year period
Retention Rate, Pre-Cancer Detection Rate (These indicators are not included currently but
may be in the future.)
Provincial, Zone
Annually
Data is currently available for (former) Calgary and Palliser regions only through Alberta
Cervical Cancer Screening Program. This is expected to be available for the entire province,
once provincial database is established; however, retrospective data will remain sourced
through Alberta Health FFS data. For the other (former) regions, data source will be the
number of distinct women screened once every three years per Alberta Health FFS data.
Page 3 of 4
Indicator
Definition
Cervical Cancer Screening Participation Rate (continued)
Document Version History
Version
1.0
Summary of
Changes
May 18, 2010
Final version for initial use.
May 31, 2010
Transfer to final approved version.
June 4, 2010
Contents for the first draft
June 5, 2010
Changed title reflect Consolidated Dashboard measurement name.
Reviewed and modified formatting.
June 30, 2010
Add approval statement.
August 11, 2010
Revised title and removed comments in the name fields.
1.2
December 23, 2010
Revised based on AHS and AB Health joint review.
1.3
January 5, 2011
Revise Business Context.
2.0
January 13, 2011
Version ready for signoff.
2.1
May 3, 2011
Full data definition signoff completed.
2.1
October 17, 2011
Update hyperlink in Cited References.
2.2
February 16, 2012
Updated AB Health Signatories
2.3
May 7, 2012
Updated Domain, Added Dimension, Titles of Contacts/Signatories
2.4
June 15, 2012
Updated naming convention, logo and signatories based on
organizational changes
2.5
December 12, 2012
Revisions based on discussion between AHS and Ministry SME’s
2.6
December 13, 2012
Update AHS Lead Analyst contact. Remove old approval statement,
update AHS signoff page.
2.7
December 19, 2012
Updated refresh rate for denominator and responsibility to produce
data.
3.0
December 20, 2012
Version ready for signoff
3.1
January 7, 2013
Update AHS Executive Lead/Sponsor
3.2
February 11, 2013
Update of AHS Operational Owner
3.3
February 15, 2013
Full data definition signoff completed.
1.1
December 20, 2012
Version
Date
Page 4 of 4