SMART DAK Cervical Cancer Screening
0.0.1 - ci-build

SMART DAK Cervical Cancer Screening, published by Dan Heslinga (independent contributor). This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/dhes/smart-dak-cxca/ and changes regularly. See the Directory of published versions

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Official URL: http://smart.who.int/cxca/ImplementationGuide/smart.who.int.cxca Version: 0.0.1
Draft as of 2026-05-14 Computable Name: CXCA

This DAK and set of implementation tools are still undergoing development.

Content is for demonstration purposes only.

Summary

This Implementation Guide is a community contribution to the WHO SMART Guidelines ecosystem covering cervical cancer screening. It is structured to be SMART-conformant at the publication boundary (FHIR profiles, CQL libraries, FSH, the CPG/CRMI/SDC/CQF Measures stack) so that downstream tooling and Community of Practice reviewers can consume it on familiar terms. It is not a WHO publication.

The DAK uses Mongolia MOH Order A/641 (2020) as a country-adaptation case study to demonstrate four methodology contributions: a bindingness model distinguishing legal vs. programmatic vs. operational regulatory positions; a NotDone pattern for explicit loss-to-follow-up tracking; a NotDone-aware cascade-completion eCQM; and a lab-capacity-as-selector axis for facility-conditional eligibility branching. See the Adapting Guidelines for Country Use page for the methodology in depth.

L1 Narrative guidelines

The clinical content in this DAK derives from:

  • Mongolia MOH Order A/641 (2020), Comprehensive Cervical Cancer Surveillance Guideline (Cyrillic title: Умайн хүзүүний хорт хавдрын цогц хяналтын заавар), signed 31 December 2020 by Health Minister T. Münkhsaikhan. The legally binding national instrument.
  • WHO 2021 Guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition. The L1 source for global cervical content.
  • WHO Mongolia news release of 22 April 2025 (Cervical Cancer Elimination Programme launch) and feature story of 16 April 2026 (Khan-Uul HPV-DNA pilot conclusion). Sources for evolving programmatic and operational positions tracked via the bindingness model.

L2 Operational guidelines

This DAK does not ship a separate xlsx-based L2 publication (the conventional WHO format). Instead, the L2 operational content — data dictionary, decision-support logic, scheduling logic, indicators — is encoded directly in the L3 machine-readable layer (this IG) and surfaced via the following navigation pages:

  • Data Dictionary — the CXCA.D and CXCA.Bindingness CodeSystems
  • Decision-support Logic — the active PlanDefinitions for screening eligibility, HPV result routing, and cytology pathway
  • Scheduling Logic — the recall scheduling layer (CXCAD18S, the LTFU-prevention process)
  • Indicators — the seven active eCQM Measure resources, including the methodology-contribution cascade-completion measure
  • Business Processes — workflow framing (BPMN authoring deferred)
  • System Requirements — capability framing (xlsx requirements doc deferred)

L3 Machine-readable guidelines

This DAK is the L3 machine-readable representation. The artifacts (FHIR profiles, CQL libraries, FSH source, PlanDefinitions, ActivityDefinitions, Measures, Questionnaires, LogicalModels) are published in this Implementation Guide. See the Artifact Index for the full inventory or Adapting Guidelines for Country Use for the methodology overview.

L4 Executable guidelines

Reference implementations (executable software hosting the L3 artifacts) are not part of this repository. Implementation work in candidate Open Technologies — particularly Google Open Health Stack on Android FHIR SDK as a candidate L4 host — is being explored separately. See Reference Implementations.

L5 Dynamic guidelines

L5 dynamic-knowledge content is out of scope for this DAK.

Contact Us

Feedback and issues can be submitted via the GitHub issues page for this DAK.

License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO License.

CC BY 3.0

For more license details please see the license page.

Providing Feedback

Feedback specific to this specification can provided through:

  • Clicking on one of the Feedbacks link to the right of any section header
  • Sending an email to SMART@who.int
  • Creating an issue on GitHub cxca repository

Disclaimer

The specification herewith documented is a demo working specification and may not be used for any implementation purposes. This draft is provided without warranty of completeness or consistency and the official publication supersedes this draft. No liability can be inferred from the use or misuse of this specification or its consequences.