Quality assurance and risk reduction guidelines

Cervical cancer continues to be a major cause of death in women worldwide. The major problem facing most women is the unavailability of screening Pap tests in poor and underdeveloped countries. While rates of cancer deaths ha ve decreased 60-80% in developed countries since the Pap test became availa ble, the accuracy of Paps was challenged recently. fn order to instill publ ic confidence and promote optimal patient care, measures to improve the qua lity, of the entire screening process should be undertaken. Continuous qual ity improvement processes are more appropriate than traditional quality ass urance monitors. Although no standards can be defined that are applicable t o all laboratory settings and nations, this document provides current views on universal quality procedures and risk reduction. Procedure/policy manua ls, workload assessment, hierarchic/peer review, discrepancy analysis, resc reening studies and cytohistologic correlation are examples of universally applicable quality teals. The variability in practices in different parts o f the world is also discussed.