BC’s cervical cancer screening rates declining

Issue: BCMJ, vol. 56, No. 4, May 2014, Page 179 News
By: Dirk van Niekerk, MD, FRCPC

Despite the many benefits of regular cervical cancer screening, fewer women in this province are getting Pap tests. Further intervention is needed to reverse this trend and drive awareness around the benefits of regular Pap tests.

British Columbia’s current cervical screening participation rate for 21- to 69-year-olds is 66%. This rate is well below the national target of 70%, and is a 5% decrease from last year’s rate. Furthermore, participation rates are significantly lower than the BC average for some regions in BC, particularly urban areas like Richmond, Vancouver, and the Fraser Valley. Retention rates are also concerning. Our provincial retention rate has seen a decline in every age group, with a 5% decline in ages 30 to 39, 40 to 49, and 50 to 59. These declines have been consistent over the past 5 years. 

There are many theories as to why women are not being screened, including misconceptions around the test, confusion about eligibility, lack of access to a family physician, lack of time, fear, embarrassment, transportation difficulties, disabilities, and literacy and language barriers. 

Primary care providers are the single biggest influencer in a woman’s decision to participate in screening. If you are a primary care physician, it is important that your eligible patients are aware that a Pap test is an excellent way to prevent cervical cancer, and the only way to detect abnormal cells in the cervix which, if left untreated, could develop into cancer.

Women should also be aware of when to start screening and at what interval to return. Our current policy recommends that women start having Pap tests at age 21, or 3 years after first sexual contact. Pap tests should be done every year for the first 3 years, then continue every 2 years if results are normal. 
Women should get regular Pap tests even if they:
•    Have had the HPV vaccine.
•    Have only had one sexual partner.
•    Have been with their partner for a while.
•    Have been through menopause.
•    Are no longer having sex.
•    Are in a same-sex relationship.

For more information on cervical cancer screening, please visit www.screeningbc.ca.
—Dirk van Niekerk, MD, FRCPC
Medical Director, BC Cancer Agency Cervical Cancer Screening Program
 

Cervical Cancer Screening Program statistics, 2012
•    501 245 women received Pap tests and 14 508 required further investigation.
•    2791 women were treated for significant cervical abnormalities, most for precancerous conditions.
•    42% of the 176 women diagnosed with cervical cancer in 2012 were 5 years or more overdue for screening or had never been screened.
•    83% of cervical cancer cases occurred in women between the ages of 30 and 69 years old.

Dirk van Niekerk, MD, FRCPC. BC’s cervical cancer screening rates declining. BCMJ, Vol. 56, No. 4, May, 2014, Page(s) 179 - News.


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