Abstract
In Canada, self-reported data from the Canadian Community Health Survey 2008 and 2012 provide an opportunity to examine overall utilization of breast, cervical, and colorectal cancer screening tests for both programmatic and opportunistic screening. Among women 50-74 years of age, utilization of screening mammography was stable (62.0% in 2008 and 63.0% in 2012). Pap test utilization for women 25-69 years of age remained high and stable across Canada in 2008 and 2012 (78.9% in 2012). The percentage of individuals 50-74 years of age who reporting having at least 1 fecal test within the preceding 2 years increased in 2012 (to 23.0% from 16.9% in 2008), but remains low. Stable rates of screening mammography utilization (about 30%) were reported in 2008 and 2012 among women 40-49 years of age, a group for which population-based screening is not recommended. Although declining over time, cervical cancer screening rates were high for women less than 25 years of age (for whom screening is not recommended). Interestingly, an increased percentage of women 70-74 years of age reported having a Pap test. In 2012, a smaller percentage of women 50-69 years of age reported having no screening test (5.9% vs. 8.5% in 2008), and more women reported having the three types of cancer screening tests (19.0% vs. 13.2%). Efforts to encourage use of screening within the recommended average-risk age groups are needed, and education for stakeholders about the possible harms of screening outside those age groups has to continue.
Highlights
Observational data and randomized controlled trials have demonstrated the effectiveness of screening, when applied in certain average-risk age groups, for reducing mortality from breast, cervical, and colorectal cancers[1,2,3,4,5,6,7]
Because of ongoing revisions to the ctfphc’s colorectal cancer screening guidelines, the present report considers the recommendations issued by the Canadian Association of Gastroenterologists, which include fecal testing every 2 years for people [50–74] years of age[12]
Self-reported population data from the 2008 and 2012 versions of the Canadian Community Health Survey[13], an ongoing national cross-sectional survey that collects health information into a database administered by Statistics Canada, were obtained to calculate screening test utilization for mammography, Pap testing, fecal testing, and endoscopy [both sigmoidoscopy and colonoscopy]
Summary
Observational data and randomized controlled trials have demonstrated the effectiveness of screening, when applied in certain average-risk age groups, for reducing mortality from breast, cervical, and colorectal cancers[1,2,3,4,5,6,7]. The success of screening depends on high participation rates in the recommended age groups. National evidence-based screening guidelines for breast, cervical, and colorectal cancer screening—which define recommended age groups, types of tests, and intervals for average-risk populations—are published and periodically updated by the Canadian Task Force on Preventive Health Care (ctfphc)[8,9,10,11] with support from the Public Health Agency of Canada (Table i). Because of ongoing revisions to the ctfphc’s colorectal cancer screening guidelines, the present report considers the recommendations issued by the Canadian Association of Gastroenterologists, which include fecal testing every 2 years for people [50–74] years of age[12]
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