Archive for August, 2009

Why does cancer of the cervix still occur?

Posted by Alex

cervix canser screeningUnderscreened populations. Women are inadequately screened for several reasons. For women to enjoy the benefits of screening, they must first undergo the test. In Prince Edward Island, 57% of women diagnosed with invasive cancer of the cervix had not previously been screened. Eighty-six percent of women older than 60 diagnosed with invasive cancer had never been screened. Despite a population-based screening program in British Columbia since 1955, 15% of all women in that province have never had a Pap test. Nationally, twice as many women between the ages of 25 and 44 were not screened in 1990 as were not screened in 1985.

Many of the unscreened women are from immigrant communities, aboriginal communities, or core areas of our cities. Other groups shown to be under-screened include those living in remote areas; single, unemployed women; low-income earners; and older women.1213 The challenge these groups of women present to family physicians is more than a lack of compliance with cervical cancer screening. They frequently feel uncomfortable and unwelcome in physicians’ offices and thus attend infrequently.

There are both physician-specific and patient-specific barriers to cervical screening. To overcome these barriers, family physicians need to make preventive care a priority. When patients attend for any reason, family physicians need to encourage all women due for screening to undergo Pap tests, especially those who have never been screened. This requires effective communication of the purpose of screening as well as of the mechanics of the test.

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Cervical cancer screening

Posted by Alex

cancer screeningMost Pap smears in Canada are performed by family physicians. Despite the tremendous success of the Pap test in reducing the incidence of cancer of the cervix in Canada, 1350 new cases and 390 deaths were predicted to occur in 1996. Incidence rates have dropped from 21.6 per 1000 in 1969 to 10.4 per 1000 in 1990. To further reduce the incidence of invasive carcinoma of the cervix, we need to examine the role of family physicians as the primary providers of screening services.

The success of screening is directly related to the percentage of the target population who are screened and the reliability of the screening test performance. Family physicians have the opportunity and responsibility to influence both of these factors.

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