Adherence to cancer screening guidelines across Canadian provinces: An observational study
Authors: Erin C. Strumpf, Zhijin Chai, and Srikanth Kadiyala
Background Cancer screening guidelines reflect the costs and benefits of population-based screening based on evidence from clinical trials. While most of the existing literature on compliance with cancer screening guidelines only measures raw screening rates in the target age groups, we used a novel approach to estimate degree of guideline compliance across Canadian provinces for breast, colorectal and prostate cancer screening. Measuring compliance as the change in age-specific screening rates at the guideline-recommended initiation age (50), we generally found screening patterns across Canadian provinces that were not consistent with guideline compliance. Methods We calculated age-cancer-specific screening rates for ages 40-60 using the Canadian Community Health Survey (2003 and 2005), a cross-sectional, nationally representative survey of health status, health care utilization and health determinants in the Canadian population. We estimated the degree of compliance using logistic regression to measure the change in adjusted screening rates at the guideline-recommended initiation age for each province in the sample. Results For breast cancer, after adjusting for age trends and other covariates, being above age 50 in Quebec increased the probability of being screened by 19 percentage points, from an average screening rate of 24% among 40-49 year olds. None of the other regions exhibited a statistically significant change in screening rates at age 50. Additional analyses indicated that these patterns reflect asymptomatic screening and that Quebec’s breast cancer screening program enhanced the degree of guideline compliance in that province. Colorectal cancer screening practice was consistent with guidelines only in Saskatchewan, as screening rates increased at age 50 by 12 percentage points, from an average rate of 6% among 40-49 year olds. For prostate cancer, the regions examined here are not compliant with Canadian guidelines since screening rates were quite high, and there was not a discrete increase at any particular age. Conclusions Screening practice for breast, colorectal and prostate cancer was generally not consistent with Canadian clinical guidelines. Quebec (breast) and Saskatchewan (colorectal) were exceptions to this, and the impact of Quebec’s breast cancer screening program suggests a role for policy in improving screening guideline compliance.
Please note that abstracts only appear in the language of the publication and might not have a translation.
Linda Kachuri, M. Anne Harris, Jill S. MacLeod, Michael Tjepkema, Paul A. Peters, and Paul A. Demers (2017).
Cancer risks in a population-based study of 70,570 agricultural workers: Results from the Canadian Census Health and Environment Cohort (CanCHEC)
BMC Cancer , 15-Jan
Thomas J. Charters, Erin C. Strumpf, and Maida Sewitch (2013).
Effectiveness of an organized colorectal cancer screening program on increasing adherence in asymptomatic average-risk Canadians
BMC Health Services Research , e449
Srikanth Kadiyala and Erin C. Strumpf (2011).
Are United States and Canadian cancer screening rates consistent with guideline information regarding the age of screening initiation?
International Journal for Quality in Health Care , 10-Jan
Alexandra Blair, Lise Gauvin, Erin C. Strumpf, and Geetanjali D. Datta (2020).
Impact of organized colorectal cancer screening programs on screening uptake and screening inequalities: A study of systematic- and patient-reliant programs in Canada
Journal of Cancer Policy
John Paul Ekwaru, Arto Ohinmaa, and Paul J. Veugelers (2020).
An enhanced approach for economic evaluation of long-term benefits of school-based health promotion programs
Nutrients , 15-Jan
Kim D. Raine, Ronald Plotnikoff, Donald Schopflocher, Ellina Lytvyak, Candace I. J. Nykiforuk, Kate Storey, Arto Ohinmaa, Lisa Purdy, Paul Veugelers, and T. Cameron Wild (2013).
Healthy Alberta Communities: Impact of a three-year community-based obesity and chronic disease prevention intervention
Preventive Medicine , 955-962
Esme Fuller-Thomson, Samara Z. Carroll, and Wook Yang (2018).
Suicide attempts among individuals with specific learning disorders: An under-recognized issue
Journal of Learning Disabilities , 283-292