Cervical Screening Coverage

Coverage is an important performance indicator for all those involved in the NCSP at both regional and national levels.

Background

An organised National Cervical Screening Programme (NCSP ) was established in New Zealand in 1990, to reduce the number of women who develop and die from cervical cancer.  The Programme recommends regular cervical screening at three yearly intervals for women aged between 20 and 69 years who have ever been sexually active.  The Health Act 1956, as amended by Part 4A in 2004, underpins the NCSP's operations to ensure the co-ordination of a high quality screening programme for all women in New Zealand.

Ongoing systematic monitoring is a requirement of an organised screening programme.  Such monitoring allows the performance of the Programme to be evaluated and corrective action to be taken as required.  Monitoring is carried out through a set of indicators which cover all aspects of the screening pathway, including participation of women, their clinical outcomes, NCSP provider performance and the performance of the Programme overall.

Coverage for the National Cervical Screening Programme (NCSP)

One of the main performance measures of NCSP is coverage. Coverage is defined as the proportion of women eligible for screening who have been screened in the previous three years. Our target is to reach 80 percent screening coverage for all eligible women, including separately for women in Māori, Pacific, Asian and European/Other population groups.

 

Access to coverage data

We are focused on providing interactive tools.

You can now access NCSP Coverage data and reports using our interactive coverage data tool.

The interactive coverage data tool replaces the monthly coverage reports. June 2017 will be the final published monthly coverage report - this and previous reports are available from our Monthly coverage data section.

The DHB Quarterly coverage reports will continue to be available.

 

Technical Notes

Screened women (the ‘numerator’) are included in the coverage calculations based on their age at the end of the monitoring period. This means that coverage for women aged 25-69 years includes women who were aged 22, 23 or 24 at the start of the monitoring period. Since February 2016 the ethnicity and domicile of a screened woman is that recorded on the Ministry of Health’s National Health Index (NHI). Prior to this date, demographic information was obtained from the NCSP Register.

The impact of this change can be found in the Calculation of Coverage for the National Cervical Screening Programme (NCSP) document which compares December 2015 coverage data, calculated using the new method for obtaining coverage numerators (counts of women screened) with what was calculated using the old method.

Any time series data produced from February 2016 will use demographic information from the NHI across all time periods.

For both numerator and denominator (eligible population), women have been prioritised to a single ethnicity using the following priority order: Māori, Pacific, Asian, European/Other. This means that if a woman chooses more than one category, and one of these is Māori, she is counted as Māori. For ease of reporting, screened women with unknown ethnicity have been classified as European/Other in the new method.

The population denominators used for calculating coverage is Statistics New Zealand’s 2014 update of DHB population projections (2013 Census base) at the end of the monitoring period adjusted for the prevalence of hysterectomy (as most women who have had a hysterectomy are not eligible for screening).

To avoid sudden shifts in coverage, the NSU produces population projections for the end of every month using a ‘prospective smoothing’ method. Annual population data is smoothed over a twelve month period starting in July for each year. For example, the 31 December 2015 population comprises 6/12 of the projected population for the year ending 30 June 2015, plus 6/12 of the projected population for the year ending 30 June 2016.

Additional detail on the methodology can be obtained via a request made to screening@moh.govt.nz

Health Quality and Safety Commission Reporting

A key function of the Health Quality and Safety Commission is to publish information about the quality and safety of health care in New Zealand.

The Commission has released a set of Health and Quality Safety Indicators that will be used to track progress in the health and disability sector in NZ and allow comparisons with other countries.

Measuring the eligible population who have been screened on time was identified by the Commission as a system level indicator to measure access to and timeliness of primary health care services. The data used to calculate this indicator is from the NCSP published national dataset on coverage.

The full report on the New Zealand Quality and Safety Indicators is available on the Health Quality and Safety Commission website.

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Page last updated: 06 April 2016