Due to rapid technology development and research, new evidence that accumulates and will continue to accumulate, enables risk-stratified screening and management of women participating in organised screening programmes. However, it is highly impractical for clinicians to integrate all this knowledge into classical, diagram based clinical algorithms that have traditionally guided clinical decisions. With the aim to overcome the complexity of clinical decisions we have decided to develop a concept of an innovative information system that would in the future enable cervical cancer screening and management of screen-positive women according to their risk for high-grade cervical lesions and cervical cancer within the organised, population based cervical cancer screening program in Slovenia.
Literature review was done to identify the most relevant information for stratifying individual risk for high-grade cervical lesion in such a way that screening, diagnostic and follow-up algorithms could be adjusted. Innovative IT supported solutions for clinical management decisions and guidance were identified in collaboration with IT experts.
The following risk-stratifying factors were considered for the screening and management: women’s age, HPV-vaccination status, screening history, screening and follow-up tests and their results, colposcopy and histology report. The concept of upgraded central cervical cancer screening information system was developed with the objective that this information will be available to the professionals involved in screening and management of the women, together with the guidance tool for the clinical decisions based on current screening and management guidelines of Slovenian cervical cancer screening program. The system is based on structured, standardised reports and process platforms. New evidence can lead to a change in screening and management guidelines. Due to high information system flexibility the changes will be implemented only by parametrisation and configuration of the system without major changes in programming code.
Organised, population based screening programmes are entering the era where innovative technology solutions and new evidence from research are accumulating rapidly. This may change the traditional role of cancer screening registries from being used as an additional system within the screening programmes that allows for monitoring and evaluation of the programme, to the central communication and decision supporting tool between the professionals involved in screening, diagnostic, follow-up and treatment of women. Such active system also enables real-time monitoring and evaluation of the program.