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Canadian Journal of Public Health

, Volume 95, Issue 5, pp 346–351 | Cite as

Access to Colposcopy Services for High-risk Canadian Women: Can We Do Better?

  • Gina S. OgilvieEmail author
  • Elizabeth A. Shaw
  • Sandra P. Lusk
  • Joyce Zazulak
  • Janusz A. Kaczorowski
Article

Abstract

Background: Despite overall decreasing mortality from cervical cancer, selected groups of Canadian women continue to have suboptimal access to diagnostic and treatment interventions for cervical cancer. In this paper, we present an evaluation of a colposcopy program developed to improve attendance for colposcopy in a lower socio-economic and immigrant population.

Methods: All women attending the North Hamilton Community Health Centre (CHC) who required colposcopic assessment and were referred to a newly developed colposcopy program based at the CHC were evaluated. Attendance rates for consultation, follow up and treatment in women referred for colposcopy were compared retrospectively for the CHC-based colposcopy program and concurrently with the regional colposcopy clinic (RCC).

Results: Women referred to the CHC colposcopy program had a significant reduction in their no-show rate after the introduction of the locally based colposcopy program (17.2% vs. 1.3%, p<0.01). Comparing the same time periods, there was no significant reduction in the default rate at the RCC (2.5% vs. 3.3%, p=0.21). Despite serving a population of women who were at higher risk for non-attendance, patients at the CHC had a default rate for appointments similar to that of the RCC (1.3% vs. 3.3%, p=0.55) after the introduction of the local colposcopy program.

Conclusions: Lower socio-economic status and immigrant women receiving care from a CHC-based colposcopy program had a significant decrease in their no-show rate for colposcopic evaluation after the introduction of the on-site program. Consideration must be given to locating diagnostic colposcopy programs in settings more accessible to women who require these services the most.

Résumé

Contexte: Malgré la baisse globale de la mortalité due au cancer du col utérin, l’accès de certains groupes de Canadiennes aux mesures de diagnostic et de traitement de ce type de cancer demeure sous-optimal. Nous présentons ici l’évaluation d’un programme de colposcopie visant à améliorer la participation à la colposcopie dans une population immigrante et de faible niveau socio-économique.

Méthode: Nous avons évalué toutes les clientes du Centre de santé communautaire de North Hamilton devant être évaluées par colposcopie et ayant été aiguillées vers un nouveau programme de colposcopie offert sur place, au centre de santé. Les taux de participation aux séances de consultation, de suivi et de traitement chez ces femmes ont été comparés rétrospectivement (pour le programme de colposcopie du centre de santé) et par rapport aux taux observés à la clinique régionale de colposcopie.

Résultats: Les femmes aiguillées vers le programme de colposcopie du centre de santé présentaient une baisse significative de leur taux de non-présentation aux rendez-vous après l’instauration du programme de colposcopie local (17,2 % contre 1,3 %, p<0,01). Sur la même période, il y n’y a pas eu de baisse significative dans le taux de non-présentation à la clinique régionale (2,5 % contre 3,3 %, p=0,21). Bien que le centre de santé desserve une population de femmes ayant un risque de non-participation plus élevé, les patientes du centre affichaient un taux de non-présentation aux rendez-vous semblable à celui des patientes de la clinique régionale (1,3 % contre 3,3 %, p=0,55) après l’instauration du programme de colposcopie local.

Conclusions: Les femmes immigrantes et de faible statut socio-économique qui recevaient des soins dans le cadre d’un programme de colposcopie offert dans leur centre de santé communautaire affichaient une baisse significative de leur taux de non-présentation aux rendezvous de colposcopie après l’instauration d’un programme sur place. Il faudrait donc envisager l’implantation de programmes de colposcopie diagnostique dans des lieux plus accessibles aux femmes qui ont le plus besoin d’un tel service.

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Copyright information

© The Canadian Public Health Association 2004

Authors and Affiliations

  • Gina S. Ogilvie
    • 1
    Email author
  • Elizabeth A. Shaw
    • 2
  • Sandra P. Lusk
    • 2
  • Joyce Zazulak
    • 2
  • Janusz A. Kaczorowski
    • 2
    • 3
  1. 1.Department of Family Practice, Division of STD/AIDS ControlUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Family MedicineMcMaster UniversityHamiltonCanada
  3. 3.Department of Clinical Epidemiology & BiostatisticsMcMaster UniversityCanada

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