A R Spence1, A Alobaid2, P Drouin3, P Goggin4, L Gilbert5, D Provencher3, P Tousignant6, J A Hanley7, E L Franco8. 1. Division of Cancer Epidemiology, McGill University, Montreal, QC. 2. Department of Obstetrics and Gynecology, King Khaled University Hospital, Riyadh, Saudi Arabia. 3. Division of Gynecologic Oncology, Centre hospitalier de l'Université de Montréal, Montreal, QC. 4. Institut national de santé publique du Québec, Montreal, QC. 5. Department of Obstetrics and Gynecology, Mc-Gill University Health Centre, Montreal, QC. 6. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC. ; Direction de santé publique de l'Agence de la santé et des services sociaux de Montréal, Montreal, QC. 7. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC. 8. Division of Cancer Epidemiology, McGill University, Montreal, QC. ; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC.
Abstract
BACKGROUND: Cervical cancer (cca) is largely a preventable disease if women receive regular screening, which allows for the detection and treatment of preinvasive lesions before they become invasive. Having been inadequately screened is a common finding among women who develop cca. Our primary objective was to determine the Pap screening histories of women diagnosed with cca in Montreal, Quebec. Secondary objectives were to determine the characteristics of women at greatest risk of cca and to characterize the level of physician contact those women had before developing cca. METHODS: The Invasive Cervical Cancer Study, a population-based case-control study, consisted of Greater Montreal residents diagnosed with histologically confirmed cca between 1998 and 2004. Respondents to the 2003 Canadian Community Health Survey and a sample of women without cca obtained from Quebec medical billing records served as controls. RESULTS: During the period of interest, 568 women were diagnosed with cca. Immigrants and women speaking neither French nor English were at greatest risk of cca. Most of the women in the case group had been screened at least once during their lifetime (84.8%-90.4%), but they were less likely to have been screened within 3 years of diagnosis. Having received care from a family physician or a medical specialist other than a gynecologist within the 5 years before diagnosis was associated with a greater risk of cca development. CONCLUSIONS: Our findings provide evidence of the need for an organized population-based screening program. They also underscore the need for provider education to prevent missed opportunities for cca screening when at-risk women seek medical attention.
BACKGROUND: Cervical cancer (cca) is largely a preventable disease if women receive regular screening, which allows for the detection and treatment of preinvasive lesions before they become invasive. Having been inadequately screened is a common finding among women who develop cca. Our primary objective was to determine the Pap screening histories of women diagnosed with cca in Montreal, Quebec. Secondary objectives were to determine the characteristics of women at greatest risk of cca and to characterize the level of physician contact those women had before developing cca. METHODS: The Invasive Cervical Cancer Study, a population-based case-control study, consisted of Greater Montreal residents diagnosed with histologically confirmed cca between 1998 and 2004. Respondents to the 2003 Canadian Community Health Survey and a sample of women without cca obtained from Quebec medical billing records served as controls. RESULTS: During the period of interest, 568 women were diagnosed with cca. Immigrants and women speaking neither French nor English were at greatest risk of cca. Most of the women in the case group had been screened at least once during their lifetime (84.8%-90.4%), but they were less likely to have been screened within 3 years of diagnosis. Having received care from a family physician or a medical specialist other than a gynecologist within the 5 years before diagnosis was associated with a greater risk of cca development. CONCLUSIONS: Our findings provide evidence of the need for an organized population-based screening program. They also underscore the need for provider education to prevent missed opportunities for cca screening when at-risk women seek medical attention.
Authors: J Hsia; E Kemper; C Kiefe; J Zapka; S Sofaer; M Pettinger; D Bowen; M Limacher; L Lillington; E Mason Journal: Prev Med Date: 2000-09 Impact factor: 4.018
Authors: Esther E Idehen; Päivikki Koponen; Tommi Härkänen; Mari Kangasniemi; Anna-Maija Pietilä; Tellervo Korhonen Journal: Int J Equity Health Date: 2018-05-04
Authors: Esther E Idehen; Anni Virtanen; Eero Lilja; Tomi-Pekka Tuomainen; Tellervo Korhonen; Päivikki Koponen Journal: Int J Environ Res Public Health Date: 2020-10-28 Impact factor: 3.390