Cervical cancer incidence in British Columbia: Predicting effects of changes from Pap to human papillomavirus screening and of changes in screening participation

Highlighting strengths and resources that increase ownership of cervical cancer screening for Indigenous communities in Northern British Columbia: Community-driven approaches

Objective

To examine the unique and diverse strengths held by rural and remote Indigenous communities in northern British Columbia, including multi‐generational support systems in health and wellness, profound connections to the land, and strong cultural foundations, and harness these strengths, allowing communities to engage in innovative and empowering health and wellness programs.

Methods

Building on these pre‐existing and fundamental strengths, an alternative option to cervical cancer screening was introduced to nine Carrier Sekani health centers located in northern interior British Columbia in response to disparities in screening rates. Introduced in 2019, CervixCheck uses a self‐collection approach that is private, safe, convenient, and offered at local community health centers by trained and supportive health staff.

Results

Using a strengths‐based and community directed and descriptive approach, the process was outlined for a successful and ongoing health screening opportunity that is put into the hands of community members within Indigenous communities in the region of northern British Columbia.

Conclusion

Through collaborative partnerships, in‐person engagement sessions, and the utilization of pre‐existing infrastructure and health and wellness teams, this project was successfully integrated into primary care centers using culturally safe and community‐based approaches.

Building on inherent strengths within rural and remote Indigenous communities leads to successful development and implementation of cervical cancer screening alternatives.

Cervical cancer screening in the Canadian armed forces: An estimation of screening participation rates using the CF-HERO surveillance system

BACKGROUND

Military women are faced with unique circumstances, including frequent relocation and occupational factors that may influence their participation in routine cervical cancer screening. No data on programmatic participation in cervical cancer screening in Canadian Armed Forces women has been synthesized to date.

OBJECTIVE

To estimate cervical cancer screening rates in Canadian military women using clinical and administrative data sources.

METHODS

Actively serving Regular Force females who were >25 years of age between January 1st 2015 and December 31st 2017 were included in the study. Scanned documents containing Papanicolaou (Pap) test results were extracted from electronic health records and further linked to demographic data sources. Screening coverage rates were calculated over the three-year study period, and results were stratified by both military command and rank.

RESULTS

The study period yielded over 23,000 person-years of data. The average screening rate over this period was 77.7 %, and was highest in the 45-60 year age group. Variations in rates were observed by rank and command, with higher screening rates observed in Officers and Royal Canadian Navy staff. Overall, screening rates showed a declining trend for all groups across the study period.

CONCLUSIONS

Cervical cancer screening rates amongst CAF members are currently below recommended guidelines and appear to be declining. These trends mirror those observed more widely in the general Canadian population, and may be a consequence of recent changes to guidelines for both cervical cancer and human papillomavirus (HPV) screening.