Trends in mammography and Pap smear utilization in Canada.

We have examined trends in the utilization of two preventive health procedures for women in Canada based on our analysis of the 1994 National Population Health Survey (NPHS) and comparisons with two previous large population health surveys. The NPHS provides evidence that Canadian women's use of mammography has continued to increase between 1990 and 1994, while use of Pap smears has remained steady. Increases in mammographic utilization are seen for all age groups and in all provinces of Canada. Women who are less than the recommended age of 50-69 years for screening mammography access these services in considerable numbers. Large proportions of women aged 18-24 and 65 or over have never had a Pap smear, and recency of Pap smear is associated with age. Income adequacy and educational attainment are still strong predictors of which women utilize Pap smears and mammograms. We conclude that the NPHS is sufficiently broad-based to be used in a surveillance program to track Pap smear and mammography utilization.