Background and objective
The implementation of evidence-based clinical guidelines for diagnosis, treatment and follow-up of cancer patients ensures better patient outcomes and equity in quality of care. Patient pathways are tools that support the planning and management of the care process of individual patients across the continuum of care. In the scope of the project European Cervical Screening Quality Assurance Update (EUCervScreenQA), led by the International Agency for Research on Cancer (IARC), supported by the European Commission - EU4 Health Programme and part of the European Commission Initiative on Cervical Cancer, we aim to design mechanisms and metrics for monitoring quality of care for cervical cancer patients in the routine practice. 
Methods
For the objective of the EUCervScreenQA project, the patient pathways visualise the care processes, describe their relationship and sequence, and map the quality indicators to be monitored by the cervical cancer care services. To design the pathways for treatment of cervical cancer patients, we used the methodology developed by the Innovative Partnership for Action Against Cancer (iPAAC) and adopted by the European Commission Initiatives on Cancer (https://cancer-screening-and-care.jrc.ec.europa.eu/en). Therefore, we started with identifying the care processes to be covered and placed them at the respective steps of the pathway, based on the existing evidence-based guidelines for staging of histologically confirmed cervical cancer, surgery, systemic treatment and radiotherapy. Then, we prioritised those topics for which to develop quality indicators considering the critical patient outcomes. After having assessed each quality indicator for scientific soundness, responsiveness and feasibility based on the evidence synthesis from a dedicated systematic review, we defined the list of quality indicators to be monitored for each pathway.
Results
We constructed six pathways: one general pathway for treatment of cervical cancer and five specific pathways on management of T1a cases; diagnostic work-up for staging; treatment of T1b1, T1b2, and T2a1 cases; treatment T1b3-4a cases; treatment of metastatic disease. We identified 18 topics for which we developed or adapted from existing resources a list of 50 quality indicators and mapped them on the respective steps in the patient pathways. They are stored in a pathway repository and will be made accessible for the public after the end of the project.
Conclusions
Designing patient pathways using a structured approach adopted by the European Commission Initiatives on Cancer allows for comprehensiveness and harmonisation in monitoring the quality of care across cancer services. The pathway repository will offer the opportunity for cancer services in different countries beyoud Europe to use the available templates and adopt or adapt them for their context.