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Preventive
Screening - Chronic Disease Prevention
Data
definitions, limitations & uses • Data Sources
A screening
program tests people for a disease or
condition before they have symptoms of the
disease. The goal of this program is to discover
conditions in there earliest and most treatable
stages. The program only works for certain
conditions where there is effective treatment, and
effective and sensitive screening tests. In these
cases, minimally invasive treatments can be used,
and improved life expectancy should result. In
this report, preventive screening for two common
conditions will be discussed: cervical cancer and
breast cancer.
Cervical cancer
screening; the Papanicolaou (PAP) test
Routine screening for cervical cancer with
Papanicolaou (Pap) testing is recommended for all
women who are, or have been sexually active, and
who have a cervix. Once a woman becomes sexually
active, she should have three Pap tests (reported
as satisfactory for evaluation ) performed at
one-year intervals. If all three are normal, the
Pap test should be repeated every two years until
age 69.
In 1996, 43% of women 18 and older, living in the
combined region of Leeds Grenville and Lanark,
Kingston Frontenac and Lennox and Addington, and
Hastings Prince Edward (LGL/KFLA/HPE) had had a
Pap test (see figure 1).
This is an increase from 1990, when only 31% of
women 18 and older in this region had ever had a
Pap. Furthermore, in 1996, the likely hood of a
woman ever having had a Pap changed with age. For
example, women 18-24, were least likely to ever
have had a Pap.
Among women 18 and older who have ever had a Pap,
77% have had a test in the past three years
(see figure 2). With
increasing age, women are less likely to have had
a Pap test in the past 3 years. For example, in
this region, 95% of women 18-24, compared to only
76% of women, 45-64, had a Pap test in past three
years.
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Female Breast
Cancer (Mammography and Clinical Breast Exams)
The Ontario Breast
Screening Program (OBSP) was established in 1990
with the mission to: "reduce mortality
from breast cancer by delivery to women 50 years
of age and over a comprehensive, organized, and
evaluated breast cancer screening program that is
sensitive to women's needs, builds on health
promotion behaviours, and fosters partnerships
with interested groups in the community".
Screening through the OBSP consists of a clinical
examination of the breasts by a trained nurse
examiner, a mammogram and a one-on-one
demonstration of breast self-examination by a
nurse examiner. Eligibility requires that
participating women must be Ontario residents,
aged 50 or over, who have no history of breast
cancer or augmentation mammoplasty, have not had a
mammogram within the last year and are free of
acute breast symptoms. There is no upper age limit
on screening in the OBSP. Since there are
currently no established methods of breast cancer
prevention, mortality reduction depends upon early
detection and appropriate therapy.
In LGL/KFLA/HPE, 56% of women 35 years of age and
older, and 78% of women 50-69, had ever had a
mammogram in 1996 (see
figure 4). This is an increase compared to
1990, when only 40% of women 35 and older and 50%
of women 50-69, had ever had a mammogram. In 1996,
a much smaller proportion of women 35 and older in
LGL/KFLA/HPE had ever had a mammogram compared to
Ontario. However, mammography is most effective in
women older than 50 and there were no differences
in the proportion of women 50-69 ever having been
screened in LGL/KFLA/HPE compared to Ontario.
The guidelines of the OBSP recommend that women
over 50 continue to be re-screened every two
years, provided they continue to meet the
eligibility criteria. In LGL/KFLA/HPE more than
80% of women 50-74 had had their last mammogram in
the last two years (see
figure 5).
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Data
definitions, limitations & uses
Preventive Screening
Pap test
Mammography
Data
Sources
Ontario Health Survey, 1990
Ontario Health Survey, 1996
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