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Centre for Chronic Prevention and Control
Cervical Cancer
Facts & Figures
Morbidity and Mortality
The mortality and morbidity rates have fallen significantly since screening began in
Canada. More specifically, over the past three decades in Canada, there has been an
overall reduction in the age-standardized mortality rates from invasive cervical cancer
from 7.4 per 100,000 females in 1969 to 2.4 per 100,000 females in 1992 and a reduction in
incidence rates from 21.6 per 100,000 in 1969 to 10.4 per 100,000 in 1990; however, since
the mid-70s the rate of decline in incidence rates has slowed, particularly among women
under 50 (Laboratory Centre for Disease Control; unpublished data). Cervical
Cancer Screening. Are the 1989 Recommendations Still Valid? 1996, CMAJ 154(12)
However, in British Columbia, as mortality and incidence rates have decreased since the
introduction of an organized program in 1949, there has been an increase in the number of
cases of in-situ carcinomas from 12.3 per 100,000 in 1955 to 133.6 per 100,000 in 1985
(Anderson, 1988). Organization and Results of the Cervical Cytology
Screening Program in British Columbia. BMJ 296 : 975-978 (1988)
Screening Practices
In the Health Promotion Surveys, women were asked whether
they had ever had a Pap smear and if yes, when was the last time they had one (less than
12 months ago, 1 to 2 years ago, more than 2 years ago and don't know). The results for
those who said they were never screened are shown in Table 1.
Table 1: Changes in Pap smear
practices, 1985 - 1990
|
% Never
Screened |
|
Age groups |
1985 |
1990 |
15 to 24 |
35 |
41 |
25 to 34 |
5 |
11 |
35 to 44 |
4 |
8 |
45 to 54 |
7 |
7 |
55 to 64 |
7 |
11 |
Stephens T., Fowler Graham D. Adapted from Canada's Health Promotion Survey
1990. Technical Report. P-179
The current approach to cervical screening has resulted in
an increasing proportion of all women reporting that they have never been screened. It is
still the older woman who is more likely never to have been screened, although there is
also an increasing number of younger women not being screened. The increasing incidence of
invasive cervical cancer in recent cohorts also reflects sub-optimal effectiveness of
current practices.
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