NATIONAL CERVICAL SCREENING PROGRAMME
ADVISORY GROUP
MINUTES TUESDAY 8 JULY 2014
Venue:
Wellington Airport Conference Centre
Start time:
9.00am
Advisory Group Members
Attendees
Apologies:
Ministry of Health
Attendees:
University of New South
Wales (UNSW) Attendees
Item
1
Gaye Tozer (Chair)
Abed Kader – New Zealand Society of Cytology
Collette Bromhead – New Zealand Institute of Medical Laboratory Science
Emily Cavana – New Zealand College of General Practitioners
Kay Lavill – New Zealand College of Primary Health Care Nurses
Kerri Nuku – Māori Community Representative
Lois Eva - Royal Australian and New Zealand College of Obstetrician &
Gynaecologist
Lynley Cook – New Zealand College of Public Health Medicine
Margaret Hand – Māori Community Representative
Margaret Sage – Royal College of Pathologists of Australasia
Mee Ling Yeong – Royal College of Pathologists of Australasia
Harold Neal, Principal Scientific Advisor, National Screening Unit (NSU)
Loga Crichton - PACIFICA
Deborah Mills – Senior Portfolio Manager, NCSP
Emma Prestidge, Programme Manager, NCSP
Hazel Lewis, Clinical Leader, NCSP
Ivan Rowe – Senior Service Development Analyst, NCSP
Jane O’Hallahan, Clinical Director, NSU
Justine Pivac Solomon – Senior Portfolio Manager, NCSP
Kirsty Craig, Senior Analyst, Monitoring and Evaluation, NSU
Margee Do – Executive Assistant, NCSP
Megan Smith, University of New South Wales (UNSW)
Karen Canfell, University of New South Wales (UNSW)
Subject and summary
Welcome, apologies and introductions
Apologies from Loga Crichton and Harold Neal.
Welcome to Emily Cavana, new member representing Royal College of
Page | 1
Action required
Item
Subject and summary
Action required
General Practitioners, and to the presence and participation of the
National Screening Unit staff members.
2
Declaration of Conflicts of Interest Register review
Chair requested that change of interest to be notified to Margee.
3
1) Advisory Group
members to advise the
Ministry of Health (the
Ministry) of any new
interests that should
be declared.
Minutes from 10 December 2013 meeting: confirmation and follow
up on actions
The minutes were accepted as a true and accurate record of the
proceedings of the previous meeting.
Summary of actions from previous meeting and update on actions:
1) LabPLUS and Canterbury Health Laboratories (CHL) have
provided ratios of their community vs hospital workload. The
Ministry will request on an annual basis
The ratio of community versus hospital workload is important context for
the rate of abnormal cytology reported by the laboratory – higher
abnormal rates can be expected if the laboratory receives a greater
proportion of smears from colposcopy clinics. No further discussion is
necessary; this is now business as usual for the Ministry. Closed.
2) Diagnostic Medlab (DML) pathologist to look at DML cases that
have gone to LabPLUS, and at abnormalities in that cohort. The
Ministry to consider whether this piece of work is still necessary,
and if so to follow up with DML pathologist as to the feasibility of
doing this work.
2) Advisory Group
pathologists to share
DML paper with
LabPlus.
Advisory Group pathologist tabled a paper prepared by the Ministry and
DML which was accepted by the group and agreed that the matter can
be closed. Advisory Group asked that the information be shared with
LabPlus. Closed.
3) The Ministry to look at two to four of the lowest DHBs (including
Auckland DHB) and analyse for three months. Closed
The Ministry’s NSU portfolio managers have followed up poor timeliness
with DHB colposcopy clinics, and this can be discussed further during
discussion of Report 40. Closed.
4) The Chair advised that while the annual report for the previous
year was written, it was not published. Will publish the previous
and current reports early next year (2015).
Updated on publication provided. 2012 summary to be sent out with
these minutes. Closed.
3) The Ministry to ensure
that 2012 annual
report summary is sent
out to the group with
these minutes.
5) Official definition of an “incident cancer” requested. The Ministry 4) Advisory Group
pathologists to follow
to circulate the relevant section of the Cancer Registry Act
up whether biopsies
legislation.
Page | 2
Item
Subject and summary
The Ministry tabled the relevant legislation and discussed “incident
cancer” definition in the Cancer Registry Act and what cases must be
reported to the Cancer Register. The Cancer Registry group had been
contacted and reported that people diagnosed with cancer who came to
New Zealand for treatment are not recorded on the Cancer Registry. It is
an incident register so it records the initial diagnosis and if that occurred
overseas they are not incident in New Zealand. The group discussed
notification of Pacific Island cases treated in New Zealand on the Cancer
Registry. It was agreed that this was still a grey area.
Action required
that are taken
elsewhere (ie in Pacific
countries) that are
reviewed at MultiDisciplinary Meetings
are reported to the
Cancer Registry.
6) Include a comment in the Reports to explain why the data is not
currently an accurate reflection e.g. women going directly to Gynae
Oncology. Include a summary of data for follow up of women with
suspicion of cancer with no histology
Comment added to monitoring report as requested. Closed.
7) Completion of colposcopic assessment fields, by DHB – the
Ministry to follow-up with Otago and Southland regarding the drop
seen from Report 38 to Report 39 for some fields.
The Ministry explained the data issue with Southern DHB and the
transition to e-colposcopy affecting the completeness of the data.
Closed.
8) The Ministry and University of New South Wales (UNSW) to work
together to rename & update Indicator 7.4 (currently ‘Timeliness of
treatment’), as timeliness not a relevant measure for low grade
squamous intraepithelial lesion (LSIL).
This recommendation addressed in report 40. Closed.
9) Follow up with DHBs who have very low results for treatment
follow-up (e.g. Counties Manukau and Tairawhiti), and low results
for appropriate discharge after treatment (e.g. South Canterbury
and Waitemata).
The Ministry outlined how performance of listed DHBs had been
followed-up. Closed.
10) Human Papillomavirus (HPV) testing and glandular lesions –
update Guidelines flow charts when they are next reissued to state
HPV testing is not indicated for glandular lesions. Also, include
story in NSU Screening Matters newsletter
Flow charts have been distributed to DHBs. Advisory Group colposcopist
described confusion around what to do with patients with glandular
lesions, and asked that the next Guideline updated includes more
information on how women with glandular lesions should be managed.
This recommendation was accepted by the Advisory Group. Closed.
11) Follow up with lab representatives around the statement on
automation (R38, p48) and whether this statement should be
removed or amended.
Report 38 was amended as required. Closed.
12) Linkage between the NCSP and HPV immunisation
programmes, including linkage between the two
registers/databases and immunisation status being on the NCSP
Register – The Ministry to consider strategies of how to achieve
this and report back to the Group.
Page | 3
5) The Ministry to lead
work on progressing
recording HPV
immunisation on the
NCSP-Register.
Item
Subject and summary
Action required
The Ministry advised that the NCSP are proactively working with the
Immunisation team and progressing early discussions on linking of
NCSP and HPV immunisation registers. The Advisory Group requested
that the Ministry progress this important matter.
4
Discussion on NCSP strategic direction
Publication of Advisory Group minutes: The group discussed whether the
minutes or a record of the NCSP Advisory Group proceedings should be
published on the NCSP website. There was no objection to publication of
the minutes. There was discussion about the detailed level of information
(scientific / clinical) required in the minutes, and this must be retained.
The NCSP will draft minutes for Advisory Group approval with publication
in mind.
6) NCSP team to
produce draft minutes
from this meeting for
Group for review.
Once agreed, the
minutes will be placed
on the NSU website.
NCSP Strategic direction: The Ministry outlined the process that will be
followed for the HPV policy work, including the intention to engage the
National Health Committee to lead the policy work. Consultation and
involvement of the sector will be part of the policy development, and this
work would be followed by an implementation phase. Any change for
NCSP will be based on NZ data and evidence, sector and Advisory
Group input and international research.
7) The Advisory Group
recommended that the
NCSP engage with
laboratories on the
workforce issues
related to HPV primary
screening and with
Health Workforce NZ.
The group offered feedback on the key policy development areas :
a) The proposed starting age – there was discussion around taking
a risk-based decision on the screening starting age.
b) The screening interval - the concern was raised that a longer
screening interval may lead to reduced screening coverage for
Māori and Pacific women. Self-screening may have benefits for
high-risk populations.
c) The role of cytology – the approximately 100 FTE laboratory
workforce understands that fewer cytoscientists will be required
with the change to HPV primary screening, and are extremely
worried about their future employment. There are risks for the
programme in retaining a highly skilled workforce and attracting
new scientists to cytology given the small number of jobs
available. The point was made that laboratories need to start
supporting staff in retraining now. Laboratories may also be
concerned about staff redundancies.
It was queried whether the NCSP strategic discussion is wider than HPV
primary screening and would the NCSP consider integrating wider New
Zealand screening programmes in terms of quality, information systems
and any efficiencies. It was noted that common information platforms
between screening programmes have been discussed at the high level
and there are issues around consent for sharing information. The first
priority for NCSP is sharing between the NCSP-Register and the
National Immunisation Register. Changes to the NCSP-Register will be
considered through any move towards HPV primary screening, and
effective management of women is the top priority. The group discussed
the value of a population based Register, a centralised register for
reporting and smear taker direct access to the Register.
The Advisory Group also recommended that the NCSP actively pursues
opportunities for integration of the NCSP with other organised screening
programmes e.g. shared data platforms, interfacing of registers, and
shared contracting/ management of programmes.
Page | 4
Item
Subject and summary
Action required
The Advisory Group also encouraged the NCSP to utilise the opportunity
provided by the HPV work programme to enable HPV immunisation
status to be recorded on the NCSP-Register. This will enable the NCSP
to monitor the impact of HPV immunisation on the NCSP.
5
Australian NCSP renewal programme
The UNSW team gave a presentation on the Australian renewal
programme. The key points from the presentation and the discussion
were:




6
Primary five-yearly HPV screening with partial genotyping from
age 25 is predicted to be both life year and cost saving and was
found to be the most favourable strategy overall.
Relative improvements in cervical cancer incidence and mortality
compared to current screening program of:
–
At least 13–15 percent.
–
Up to 22 percent, if retaining an end-age of 70 years.
–
A large increase in colposcopies is not predicted
because by 2016, women aged ≤35 years will have been
offered vaccination in Australia.
Changes will not be implemented prior to 2016.
This work has led to the following draft renewed national policy Australian women should start having HPV tests at 25 years, and
HPV tests should be undertaken every five years until age 74
years. HPV and cytology co-testing is not recommended.
Annual report 2012
The UNSW team took the group through a presentation on the 2012
annual report. Data for this report was taken from the Cancer Registry
and NCSP-Register.
Key points from the presentation and discussion were:





Page | 5
It was noted that age related trends in cancer incidence are
difficult to interpret because the confidence intervals are very
wide. However it was noted that there is low incidence in younger
ages, increasing at about 30 years. Further analysis may help to
inform screening starting age (While the cervical smear is not
designed to detect glandular cancers, the HPV test can help with
this).
It was also noted that mortality in Pacific women is quite high.
This indicates that perhaps Pacific mortality is being recorded on
the Cancer Registry (for Pacific women who die in New Zealand),
even if perhaps incidence is not recorded when biopsies are done
in the Pacific.
There were no cervical cancer deaths for Asian women in the
period, and while incidence for Māori women had decreased it
plateaued in this period.
There is one new indicator included in this report (regularity of
screening). This indicator aims to look at broader information
around screening behaviour, rather than just three yearly
screening. Discussion on the new indicator covered ongoing work
to refine the usefulness of the indicator. The indicator is to be
included in the annual reports only.
Histology rates have increased overall – this could possibly be
due to the introduction of triage with HPV testing and additional
8) The Ministry to
consider a research
question to establish if
the reduction on HG
histology presentation
at colposcopy in young
women is linked to
HPV vaccination. This
research would include
linked analysis to look
at vaccinated vs nonvaccinated cohort
9) UNSW to provide
NCSP with the NSW
research protocol on a
similar study.
Item
Subject and summary
Action required
colposcopy referrals. One graph discussed showed a reduction in
high grade rates in the 20–24 age group – this could perhaps be
an early indication of the vaccinated cohort reaching screening
age, and less presentation of cervical abnormalities in the
immunised group. This pattern is consistent with what has been
seen internationally with immunised populations. The Advisory
Group was interested in analysis of this cohort to determine
immunisation status (possibly include age at vaccination and
dose response) and confirm the interpretation of this data.
7
NCSP biannual monitoring report 40
The UNSW team presented key points arising from report 40. Key points
from the presentation and discussion were:









Page | 6
Coverage data - Small numbers of women withdrew from the
programme in the period and there is continued success in
reducing early re-screening.
Three year coverage was 76.4 percent and four of 21 DHBs met
the coverage target of 80 percent. The five year coverage is 90.4
percent. It was also noted that coverage in 30–34 year age group
is trending down.
There was general discussion about coverage, lack of any recent
social marketing or communications campaign and the potential
positive impact on cervical screening from its inclusion in
Integrated Performance and Incentive Framework (IPIF).
Reducing coverage for the younger women age group indicates a
need for a new social marketing campaign targeted at women
aged 25–40. There is a risk that poor screening coverage in the
30–40 age group could turn into poorer screening coverage of
this group over their whole life.
Laboratory data – the NCSP is consulting further with
laboratories on development of the new “accuracy of negative
cytology” indicator.
Colposcopy data – Discussion on Indicator 7.2 – timeliness of
colposcopic assessment of low grade cytology result –
Discussion on whether impact on timeliness is due to capacity of
clinic (e.g. staffing issues) or client behaviour (e.g. Rescheduling
or DNA) and the reasons aren’t able to be separated from the
data at present.
Of the histology data on the NCSP-Register, only around 70
percent has corresponding colposcopy visit information. This
must indicate missing colposcopy data in the NCSP-Register.
The Advisory Group recommended that the NCSP team
determine the cause of this missing information, particularly as it
impacts all of the colposcopy data contained in the monitoring
report.
HPV testing – Lakes DHB is an outlier in terms of the number of
HPV tests requested. NCSP team to discuss this with Lakes
DHB.
There was discussion of indicator 6: women with high grade
cytology, but no histology. There was a difference in views on the
interpretation of this indicator. Possible reasons why there may
not be biopsy histology results for women are that they are
pregnant (therefore biopsy is delayed) or they go straight to
excisional biopsy.
10) The Ministry should
give consideration to
targeting the upcoming
social marketing
campaign at 25–40
year old women. Māori
and Pacific women are
still to be a focus for
this campaign too.
11) The Ministry to follow
up on accuracy of the
completeness of
colposcopy records in
Auckland DHB,
Waitemata,
Whanganui, Lakes,
Bay of Plenty.
12) The Ministry to followup number of HPV
tests at colposcopy at
Lakes.
13) The Ministry to clarify
interpretation of the
indicator with
colposcopy clinics.
Item
8
Subject and summary
Action required
P16/Ki67
A presentation was given by one of the Advisory Group pathologists on
the dual staining molecular marker, which helps to detect unregulated
cell proliferation. It was recommended that a study in New Zealand on
dual staining by undertaken and a discussion was held on the potential
benefits of the stain as part of the NCSP.
The stain is now available for use with an automated staining kit. Another
pathologist warned that the methodology must be standardised and the
workforce trained very well – this includes scientists and pathologists.
9
Monitoring of HPV testing
A list of research questions and data analysis that the laboratory sector
would like to see the NCSP complete was presented. This request was
noted by the Advisory Group and it was considered that each point
raised needed more discussion and consideration.
Key points from the discussion were:
14) The Ministry to followup on these requests
with laboratory
representatives at their
next scheduled
meeting.
a) monitoring HPV negative, high-grade positive rates to determine
the false negative rate of HPV in New Zealand. There is a lot of
international research on this, and the false negative rates for
HPV are much less than for cytology. There was discussion
around using a similar research framework to previous Women in
HPV study. NCSP has no capacity to lead this work at this time,
but understands the desire to complete the work as we move
toward primary HPV testing.
b) performance standard for atypical squamous cells of
undetermined significance (ASCUS) and LSIL concurrent HPV
positivity rates. There was no support from the Advisory Group for
combining ASCUS and LSIL rates.
c) tracking women with ASCUS cytology and HPV negative results
for women – aim is to determine if we are over reporting ASCUS.
d) tracking women with negative cytology for their outcomes – this is
done in some way through 42 month look back. It may be
possible to look at data for women with negative results and
compare with long term outcomes.
e) monitoring “referral value” (a United Kingdom performance
measure) – monitors the number of women referred to
colposcopy to detect one high grade outcome.
10
General business
Timeliness of monitoring reports – agreed that the reports can be sent
out in draft to facilitate more timely sharing of information.
Page | 7
15) The Ministry to send
an email to the
laboratory and
colposcopy sectors
when Independent
Monitoring Reports are
available in draft.
Item
Subject and summary
This was the last advisory group meeting for Dr Mee Ling Yeong and Dr
Margaret Sage, as their terms have ended. The NCSP team and the
Advisory Group thank Mee Ling and Margaret for their superb
contributions to the group and are sorry to see their terms come to an
end.
Meeting closed 3:52pm
The next Advisory Group meeting is scheduled for 25 November 2014.
Page | 8
Action required
Appendix 1: Annual Report 2011
NATIONAL CERVICAL SCREENING ADVISORY GROUP
Annual Report December 2011
At its July 2011 meeting the National Cervical Screening Programme (NCSP)
Advisory Group (‘the Group’) agreed to publish an annual report on the NCSP
website. The purpose of the report is to ensure accountability to the Ministry
of Health and the public, and to provide the appropriate level of visibility of the
work of the Group.
Terms of Reference for the NCSP Advisory Group were reviewed during 2010
at which time the role of the Group was revised. It was agreed that the Group
operates to:




Review, critique and interpret the NCSP monitoring report data and
make recommendations to the National Screening Unit
Provide advice on the strategic direction of the Programme
Provide advice from time to time on other areas of the Programme as
agreed by the Group and the National Screening Unit
Help build understanding and partnership with consumer and
professional groups.

The Group expects that its advice will be considered and implemented as far
as practicable.1
This first Annual Report presents the work of the Group during 2011.
Presentation of independent monitoring reports was significantly delayed
during 2010 while the National Screening Unit (NSU) completed negotiations
for a new independent monitor. The focus of the Group during 2011 has
necessarily been on catching up on the review of reports from previous
periods. This has been a demanding task and it has compromised the time
available to address the Group’s wider accountabilities. Opportunities to
debate strategies for implementation of recommendations have also been
limited. It is pleasing to report however that a timely review of monitoring
reports is now possible and the Group looks forward to a more balanced
agenda for future meetings.
Membership of the Advisory Group changed over the period as three-year
terms for some members ended. Collette Bromhead (representing the New
Zealand Institute of Medical Laboratory Science), Te Kani Moore and
Margaret Hand (representing the Māori community and consumers), Lois Eva
(representing the Royal Australian and New Zealand College of Obstetrics
and Gynaecology) and Loga Crichton (representing Pacifica) have been
welcomed to the group. Mele Wendt (Pacifica), Sue Pullon (New Zealand
College of General Practice), Edwin Ozumba (Royal Australian and New
Zealand College of Obstetrics and Gynaecology), Liz Pringle (New Zealand
Institute of Medical Laboratory Science) and Beth Quinlin (Consumers) were
thanked for their contribution.
1 NCSP Advisory Group, Terms of Reference, December 2010
Appendix 1: Annual Report 2011
The Cancer Epidemiology Unit within the Cancer Council of New South Wales
(CCNSW) prepares and presents the monitoring reports - in collaboration with
the NSU. During 2011 the Group reviewed reports for the periods JanuaryJune 2010, July-December 2010, Annual Report 2010, and January-June
2011.
Forty-four recommendations were made to the CCNSW with a view to
ensuring comprehensive, accurate, clear and consistent reporting, which also
reflects developments in the immunisation, laboratory and cervical screening
areas. The Group also developed operational and strategic recommendations
for the NSU to consider.
Consumer representatives noted that the process for withdrawing from the
Register was not always accessible to women. The Group recommended that
the process documented in Section 4 of the Policies and Standards should
make it clear that women who do not wish to have any letters regarding
smear tests need to make this known to their smear taker in order not to
receive practice-generated correspondence.
Accuracy of adenocarcinoma reporting rates was discussed at the July
meeting and the NSU was asked to undertake actions to improve the
situation, including the completion of an analysis of coding errors and the
investigation of acceptance of codes by the Register, further discussion with
the Pathologist members of the Group on the sharing of this information with
laboratories and the inclusion of adenocarcinoma coding in laboratory audits.
Low coverage across metropolitan Auckland continues to cause concern.
The Group asked the NSU to investigate the reporting of NCSP Register data
by Primary Health Organisation (PHO), as well as by DHB – given the
significant role of PHOs and their member practices in the recruitment and
participation of women in the Programme. High levels of early re-screening in
this region are apparent and the Group looks forward to a report from the
NSU on meetings held with the District Health Boards in late 2011 to develop
strategies for addressing these issues.
Incomplete reporting against the colposcopy indicators continues to be of
concern. A number of the indicators are still under development. Data has
been recorded on the Register (for a shorter period than cytology and
histology data) however it is not a complete set. Notwithstanding these
constraints, the Group agreed that reports against the colposcopy indicators
should be published for the first time in Monitoring Report #36, with the
appropriate cautionary note relating to completeness.
The Report of the Parliamentary Review Committee regarding the New
Zealand Cervical Screening Programme was published on 22 July 2011. It
was pleasing to note the view of the Committee that the NCSP ‘has achieved
significant gains by decreasing the burden of disease relating to cancer of the
cervix …’2 however there were a number of recommendations for
2 Report of the Parliamentary Review Committee regarding the New Zealand Cervical Screening
Programme, 22 June 2011, Commissioned by the New Zealand Government, p. 8
Appendix 1: Annual Report 2011
improvement made in the areas of quality assurance and monitoring,
organisational, structural and workforce issues, ethnicity and inequalities, the
Register, Colposcopy and HPV vaccine and testing. Of particular relevance
to the Advisory Group are the comments relating to ‘better cohesion between
the NCSP Advisory Group and the NSU (which) would better realise the full
advantages of the expertise and skills within this group’3 and ‘The two
remaining NCSP advisory groups must have a stronger role and function to
ensure an adequate voice and presence for consumer and women’s groups.’ 4
The Chair of the Advisory Group has advised the Ministry of Health of the
Group’s interest in participating in activities to address these Review
recommendations.
Notwithstanding the focus on monitoring reports during this period,
recommendations of a more strategic nature have emerged and it is hoped
that 2012 will provide greater opportunity for discussion on these issues – and
for a contribution to be made to the Ministry’s work to address the
recommendations of the Parliamentary Review Group’s report.
My sincere thanks to the members of the NCSP team for their support of the
Group’s activities and for the commitment of the CCNSW to bringing the
monitoring reports to the Group for review.
Gaye Tozer
Chair, on behalf of the NCSP Advisory Group.
3 Ibid p.8
4 Ibid p.48
Appendix 2: Annual Report 2012
NATIONAL CERVICAL SCREENING ADVISORY GROUP
Annual Report December 2012
The National Cervical Screening Programme (NCSP) Advisory Group (‘the
Group’) publishes an annual report on the NCSP website. The purpose of the
report is to ensure accountability to the Ministry of Health and the public, and
to provide the appropriate level of visibility of the work of the Group.
The Advisory Group operates to:




Review, critique and interpret the NCSP monitoring report data and
make recommendations to the National Screening Unit
Provide advice on the strategic direction of the Programme
Provide advice from time to time on other areas of the Programme as
agreed by the Group and the National Screening Unit
Help build understanding and partnership with consumer and
professional groups.

The Group expects that its advice will be considered and implemented as far
as practicable.5
This Report presents the work of the Group at meetings held in July 2012 and
February 2013 (originally scheduled for December 2012).
Lois Eva, representing the Royal Australian and NZ College of O&G, and
Loga Crichton, PACIFICA, were welcomed to the Group at the July meeting;
Liza Lack, representing the NZ College of General Practitioners, commenced
attendance in February. Jane O’Hallahan, recently appointed as Clinical
Director for the NSU was also welcomed.
The meetings continued to focus on the review of monitoring reports prepared
and presented by the Cancer Council New South Wales (CCNSW).
Monitoring Report 36 (covering the period July – December 2011) was
reviewed in July and provisional information for the 2010-2011 Annual Report
was also presented for comment. Monitoring Report 37 (covering the period
January – June 2012) was reviewed in February.
Consideration of the Monitoring Reports generated recommendations for the
CCNSW to consider, with a view to ensuring comprehensive, accurate, clear
and consistent reporting, which also reflects developments in the
immunisation, laboratory and cervical screening areas. Recommendations
were also made for the NCSP to action relating to matters such as laboratory
case mix, timeliness of colposcopy assessment, the adequacy of colposcopy
assessment documentation, ethnicity recording on the Register and HPV
vaccination rates.
5 NCSP Advisory Group, Terms of Reference, December 2010
Appendix 2: Annual Report 2012
The Group was particularly concerned to note the ongoing inadequacy of
recorded colposcopy data and a letter was sent from the Chair to the Ministry
of Health expressing this view and the support of the Group for the
development of a national colposcopy database. The Chair was also asked to
expedite enquiries into the status of the project to consolidate laboratory
services.
With the monitoring reports now up to date the Group welcomed the
opportunity to include other items for discussion on the agenda. The CCNSW
presented the work underway on Modeling HPV primary cervical screening
strategies in New Zealand to determine cost effectiveness and the NCSP
Clinical Lead presented the draft protocol for Conservative management of
CIN2 in women under 25 – PRINCess study being undertaken by the
Department of Obstetrics and Gynaecology and the University of Otago,
Christchurch.
NCSP reports on progress towards achieving the strategic objectives, other
key operational issues and an update on the recommendations from the
Parliamentary Review Committee Report were presented at both meetings.
The Group appreciates this opportunity to develop an understanding of the
work of the NCSP and the challenges involved. HPV coverage data and
PHO coverage data was tabled – as recommended by the Group at a
previous meeting.
The Ministry has audited the management of Conflicts of Interest for members
of Committees/Advisory Groups. An Interests Register has been established
for the Group and an Interests Register Review is now a standing agenda
item.
Kirsten Coppell has been an Advisory Group member for five years, during
which time she has contributed valuable knowledge, challenges and ideas.
Kirsten was thanked for her commitment to the programme and to the work of
the Group.
My sincere thanks to the members of the NCSP team for their support of the
Group’s activities, for the commitment of the CCNSW to bringing the
monitoring reports to the Group for review, and to the members of the
Advisory Group for their time and expertise.
Gaye Tozer
Chair, on behalf of the NSCP Advisory Group.