JCC pilots new cervical cancer screening program linked with CytoBase

A simple test can save many women from a preventable cancer. The Pap test, used for cervical screening, is the most successful screening tool and has the highest outcome of detecting cancer. Yet, an estimated 510 new cases of cervical cancer will be diagnosed in Ontario this year

“There would be a 91 per cent reduction in cervical cancer rates if women were being regularly screened every three years. Despite this incredible statistic, an estimated 50 per cent of women do not get the Pap test according to guidelines,” says Dr. François Moens, Gynecologic Oncologist at the Juravinski Cancer Centre.

Tia Geminiuc, knows from experience the importance of regular Pap tests. In 2002, when Tia was 32 years old, she had two consecutive Pap tests with abnormal results. She was then diagnosed with inoperable cervical cancer. Had the cancer been diagnosed just one year earlier, Tia believes it may have been caught at a stage when surgery was still possible.

Raising awareness around the need for increased cervical screening for eligible women is the goal of an innovative new pilot study for the Juravinski Cancer Program at HHS in partnership with St. Joseph’s Healthcare, the Hamilton Regional Laboratory Medicine Program, local family physicians and CytoBase, the provincial registry for cytology results established by community laboratories.

The Juravinski Cancer Centre (JCC) pilot study is designed to build on the success of the Ontario Breast Screening Program (OBSP) family physician model of recruitment. Initially, eligible women receive a letter from their family physician inviting them to be screened. Women are recalled later for follow-up screening as required. One of the goals of the organized screening program is to reach out to women who have never been screened and who are at higher risk for developing cervical cancer by age. Recall programs in other jurisdictions have demonstrated a significant increase in rates of screening, and a subsequent reduction in cervical cancer rates.

“A tremendous number of people are not being screened. This implementation program will improve the ability of physicians to identify and recall patients appropriately,” said Moens.

When the study began, only family physicians that used private laboratories could participate because hospital laboratories did not submit to CytoBase. The centralized database system enables registered laboratories to submit gynecological results from which patient histories can be obtained to assist the interpretation of new samples.

Participation is voluntary and up until now, only private sector laboratories were submitting their results which make up an estimated 90 per cent of all PAP test results in Ontario. The remaining 10 per cent of all PAP test results reside in hospital databases. For the JCC pilot project to be successful, a complete database of women who are taking advantage of cervical screening on their own is required. Consequently, the Hamilton Regional Laboratory Medicine Program and the Juravinski Oncology Program have collaborated making Hamilton Health Sciences and St. Joseph’s Healthcare the first group of hospitals in Ontario to link with the Provincial Cytology registry, CytoBase.

“This collaboration among family physicians, hospital and private laboratories, Cytobase, hospitals and the cancer centre is unique in Ontario,” said Carol Rand, Director, Systemic, Supportive Care and Regional Programs, Juravinski Cancer Program.

“The potential benefits of this initiative are significant and will hopefully bring more accurate diagnosis, earlier treatment of abnormalities and assurance that follow-up procedures will not be overlooked.”

Tia underwent five weeks of radiation and chemotherapy treatment to destroy the cancerous tumour following her diagnosis. It took several months for Tia to overcome the side effects she experienced following treatment.

Fortunately, Tia’s cervical cancer has been in remission since 2004, but she is still closely monitored every three months to check for abnormalities in her cervix.

The JCC pilot study will help family doctors identify and recall patients appropriately, however Tia openly shares her story with women because she believes women need to be proactive about their health and take care of themselves.

“What I’ve learned through my experience is that we have a great health-care system, but people need to know how to use it. Women need to change their mindset about cervical screening and do it regularly.”