Quality control indicators and standards used in detection and treatment of precancerous lesions of the uterine cervix

Izhodišča. Visoka incidenca raka materničnega vratu (RMV) v Sloveniji po letu 1990 je nesprejemljiva ob dejstvu, da smo s pasivnim lokalnim presejalnim programom že uspešno znižali zbolevanje zaradi RMV v 70. letih ter da je danes na voljo razvejana mreža tako ginekologov kakor citologov. RMV je, glede na izkušnje drugih, ob ustrezni organizaciji brez dvoma obvladljivi rak. Metode. Analiza ukrepov in stanja v razvitih državah, domače raziskovalne naloge, analize, ankete in številni strokovni izsledki, objavljeni tako v domačem kot mednarodnem prostoru, so evidentirali večino najbolj verjetnih razlogov za povečano incidenco RMV v Sloveniji. Zaključki. V Sloveniji smo sprejeli ali že uvedli nekatere najpomembnejše ukrepe za izboljšanje stanja. Zastavljeni cilj bi bilo moč uresničiti v petem do osemletnem obdobju, vendar le pri pregledovanju žensk v Sloveniji, kot jih zahtevajo merila za uspešno aktivno presejanje, na eni strani, ob izboljšani kakovosti nekaterih najpomembnejših diagnostičnih postopkov na področju ginekologije in citologije, ki so skladu s pripravljenimi protokoli in priporočili, na drugi strani.Background. In Slovenia the high incidence of cervical cancer after 1990 is unacceptable knowing that the local passive screening programme efficiently decreased the incidence of cervical cancer in the 1970\u27, and that at present a well branched network of gynecologists and cytologists is available. Methods. The analysis of measures and actual situation in developed countries, national studies, analyses and numerous evidence-based conclusions published in Slovenia and world-wide, have resulted in the set of most probable causes of the increased incidence of cervical cancer in Slovenia. Conclusions. Some most relevant measures of decreasing the occurrence of cervical cancer have been planned and some have also been undertaken. The planned goals could be realized in a 5-to 8-year period, under certain conditions: if examination of the Slovene female population stricly following the criteria for efficient active screening is guaranteed, and if most relevant diagnostic procedures in the fields of gynecology and cytology are improved according to the prepared protocols and recommendations