Less than 50% of women with abnormal Paps receive follow-up care: study

    Researchers find gap in cancer screening in Ontario based on income

    TORONTO, Aug. 20 /CNW/ - Less than half of Ontario women with abnormal
Pap tests receive recommended and potentially life-saving follow-up care,
according to a new women's health study by researchers at St. Michael's
Hospital and the Institute for Clinical Evaluative Sciences (ICES). What's
more, low-income women are less likely to be screened for cancer compared to
their high-income counterparts.
    "Cervical cancer is one of the most preventable forms of cancer, yet in
Ontario more than one million women have not been screened, and a
disproportionate number of these are women living in lower-income
communities," says Dr. Arlene Bierman, a physician at St. Michael's Hospital
and principal investigator of the Project for an Ontario Women's Health
Evidence-Based Report (POWER). "We need to make special efforts to reach women
who are screened, but do not receive the necessary follow-up and may
eventually fall through the cracks. To improve surveillance and treatment, we
need a system that ensures all abnormal Pap tests are followed-up so that
Ontario women can receive the best care possible," added Dr. Bierman, a
researcher at ICES.
    The joint study titled POWER (the Project for an Ontario Women's Health
Evidence-Based Report), from St. Michael's Hospital and the Institute for
Clinical Evaluative Sciences (ICES), is the first in the province to provide a
comprehensive overview of women's health in relation to gender, income,
education, ethnicity and geography. The findings are detailed in the report
titled Cancer - the second to be released this year as part of the study.
Findings can be used by policymakers and health-care providers to improve
access, quality and outcomes of care for Ontario women. Dr. Monika
Krzyzanowska, a medical oncologist at Princess Margaret Hospital/University
Health Network is the lead author on the cancer chapter. The POWER Study is
funded by Echo: Improving Women's Health in Ontario, an agency of the Ontario
Ministry of Health and Long-Term Care.
    According to the study, less than 50 per cent of women who had a Pap test
that showed a low-grade abnormality had the appropriate follow-up care within
the recommended time frame, including either a repeat test or colposcopy (a
medical procedure that examines a woman's cervix and vagina). This is usually
the group at greatest risk of eventually developing cervical cancer and
therefore in greatest need of appropriate care. Timely follow-up of abnormal
results is essential for cancer screening to work appropriately.
    "According to the Cancer System Quality Index, between 2005-2007, 56 per
cent of eligible women in Ontario completed all the cancer screening
recommended for their age group," said Dr. George Pasut, vice president,
Prevention and Screening, Cancer Care Ontario. "We need to continue to work to
reach underscreened populations. This includes focused approaches to improve
awareness of screening and access to screening and follow-up services." The
study found screening rates in Ontario for both breast and cervical cancers
remain below provincial targets, despite the existence of long-standing
screening programs for both cancers.
    Women from lower-income neighbourhoods were at risk with consistently
lower rates of screening for breast, colorectal and cervical cancer than women
living in higher-income neighbourhoods. While the overall rate of cervical
cancer screening in Ontario women was 69 per cent in the study, only 61 per
cent of low-income women were screened compared to 75 per cent of high-income
    "The findings are compelling," says Pat Campbell, CEO of Echo. "Clearly,
the challenge for our health-care system is to help lower-income women and
men, get early access to screening, diagnosis and treatment. This will require
more patient-oriented services and understanding and removing the barriers
that limit participation in health-care programs."
    For more information on the POWER Study and its partners visit
www.powerstudy.ca. Other findings from the study will be released later this
    Dr. Arlene Bierman is a researcher in the Keenan Research Centre at the
Li Ka Shing Knowledge Institute of St. Michael's Hospital, a scientist at ICES
and Echo's Ontario Women's Health Council Chair in Women's Health at St.
Michael's Hospital and the University of Toronto (Lawrence S. Bloomberg
Faculty of Nursing).

For further information:

For further information: Deborah Creatura, ICES, (416) 480-4780; Julie
Saccone, St. Michael's Hospital, (416) 864-5047; Lenore Bromley, Cancer Care
Ontario, (416) 971-9800 ext. 3383

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