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Study shows disparities in cervical cancer screening

Nearly 40 per cent of women living in Ontario’s metropolitan areas are not getting appropriate cervical cancer screening.

Toronto, August 11, 2010

Photos of Dr. Rick Glazier Dr. Rick Glazier

New research from the Institute for Clinical Evaluative Sciences (ICES) and St. Michael’s Hospital found that despite Ontario’s system of universal health insurance, appropriate cervical cancer screening is significantly lower among women who are older, living in low-income areas, or recent immigrants.

The Pap test has proven to be a highly effective screening tool for cervical cancer. Due to widespread use in Canada, incidence and mortality rates for cervical cancer decreased by 39 per cent and 53 per cent, respectively, between 1981 and 2002. In Ontario, evidence-based guidelines recommend the initiation and frequency of screening, stating that Pap tests should begin within three years of first vaginal sexual activity, and should be performed at least every two to three years until the woman reaches 70 years of age.

“Ontario has a single, government-run, universal health insurance plan that pays for all medically necessary services, including cervical cancer screening. In spite of an effective screening tool, established guidelines, and a universal health plan, certain groups of women in our setting appear to be inadequately screened,” says Rick Glazier, co-author and Senior Scientist at ICES. The population-based study of 2.3 million women aged 25-69 who lived in Ontario's metropolitan areas during the calendar years 2003, 2004 and 2005, all of whom should have been screened for cervical cancer at least once during that time period.

“Our findings have found that age, income and immigrant status all play significant roles in cervical cancer screening in Ontario’s metropolitan areas despite a universal health care system. Targeted interventions with particular focus on the immigrant composition of various health regions may be essential to closing the screening gap,” says Glazier.