Key message
Self-reported Pap testing rates are high across Canada.
Indicator definition
The percentage of women aged 25–69 who reported being up to date on cervical cancer screening, defined as having had at least one Pap test in the previous three years. Results are presented by province/territory using data from the 2012 Canadian Community Health Survey.
Target
80% of women participating in Pap testing. Applied to system performance reporting as of 2015 to align with the Pan-Canadian Cervical Screening Network’s programmatic participation target.
Measured since
The 2009 Cancer System Performance Report.
The indicator definition was revised in 2016 to better reflect the guidelines of the Canadian Task Force on Preventive Health Care (CTFPHC), which indicate screening should begin at age 25.1
Why measure this?
Cervical cancer screening guidelines from the CTFPHC recommend routine screening every three years starting at age 25 for asymptomatic women who have ever been sexually active.1 While most provincial screening programs begin cervical cancer screening at age 21, this indicator was defined to show the proportion of the population protected against cervical cancer as prescribed by the CTFPHC guidelines. These recommendations balance the benefits of cervical cancer screening (i.e., reductions in cervical cancer incidence and mortality) with its associated harms (e.g., false positives).
What are the key findings?
- Self-reported Pap testing rates for women aged 25–69 ranged from 71.7% in Quebec to 88.7% in Prince Edward Island in 2012 (Figure 2.1).
- Ten provinces/territories (British Columbia, Alberta, Manitoba, Ontario, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Yukon and the Northwest Territories) had Pap testing rates that exceeded the 80% participation target in 2012 (Figure 2.1). When taking into account statistical margin of error, only Quebec did not reach the target.
Why do these findings matter?
Self-reported participation in cervical cancer screening was found to be high across Canada, with most provinces and territories achieving the 80% participation target in 2012. This target is being compared with self-reported screening rates for the purposes of system performance reporting, which includes all screening activity, both programmatic and non-programmatic (unlike the program target, which includes only programmatic screening). As of July 2015, women can access screening through organized cervical cancer screening programs, which exist in all Canadian provinces except Quebec and Prince Edward Island,2 or opportunistically (without going through an organized screening program).3 Monitoring cervical cancer screening participation rates at the system level facilitates evaluation of practices across the country, identifies what proportion of women are protected against this screenable cancer and can help to identify targeted interventions that will increase the proportion of the population accessing screening and receiving treatment when it is most effective.
References
- Canadian Task Force on Preventive Health Care, Dickinson J, Tsakonas E, Conner Gorber S, Lewin G, Shaw E, et al. Recommendations on screening for cervical cancer. CMAJ. 2013;185(1):35-45.
- Cancerview.ca. Cervical Cancer Screening Guidelines Across Canada: Environmental Scan. Toronto (ON): Canadian Partnership Against Cancer; 2015 Jul.
- Canadian Partnership Against Cancer. Cancer Screening in Canada: An Overview of Screening Participation for Breast, Cervical and Colorectal Cancer. Toronto (ON): Canadian Partnership Against Cancer; 2015 Jan. 30 p.
