Cervical cancer screening in Canada: 2021/2022

Strategies to improve cervical screening for all eligible people

Eight provinces employ strategies to improve cervical screening for all eligible people. Many use social media campaigns, presentations, and program materials to increase awareness and education on cervical screening. The use of client reminders is a prevalent strategy to increase screening participation and access.

Strategies to improve cervical screening for all eligible people*

P/T Strategies used Description of activities to improve cervical screening for all eligible people
BC · Recall notices to patients were implemented in 2021. Facilitated referral for colposcopy was implemented in 2021. Various promotion activities are completed annually.
AB · Education (one on one and group)
· Client invitation and reminders
· Media (small and mass)
· Provider reminders and recall systems
· Provider assessment and feedback
· Healthcare provider cultural competency training
· Development of culturally safe materials and resources
· Program developed materials are in plain language.
· Share evidence and learnings with service providers to provide culturally safe care.
· Inclusive language in Standards and Guidelines.
· Work with our partners to provide consistent messaging to eligible people.
· Work with partners to provide providers with their annual panel reports on screening.
· Ongoing communication about screening through profession associations and colleges.
· Ongoing analysis of target population to better understand screeners and non-screeners.
SK · Education
· Client reminders
· Media
· Provider reminders
· Knowledge translation
· As part of the Accelerating Innovations to Build Resilience in Cancer Screening during COVID-19 project, revised clinician resources are being revised and or created (e.g. clinician training videos); knowledge translation strategies at the population, community and individual client levels are being readied and will be implemented in the next year.
MB · Education – public & provider
· Extensive invitation campaigns
· Provider reminders and client fail safe letters
· Cross screening program awareness
· Extensive web site with Pap clinic maps
· Healthcare provider competency training
ON · Correspondence campaigns (invitation, recall and reminder letters)
· Media
· Public education and awareness campaigns
· Provider reminder and recall systems (Screening Activity Reports)
· Education to primary care providers and colposcopists
· Provider incentive strategies
· The Ontario Cervical Screening Program sends letters to eligible people inviting them to participate in screening by talking to their PCP and reminding participants when it is time for their next screening test (recall letter).
· In Ontario, the Ministry of Health is responsible for carrying out province wide public awareness campaigns.
· The Ontario Cervical Screening Program provides materials to Regional Cancer Programs to support cervical screening awareness initiatives such as Cervical Cancer Awareness Week (e.g., posters, postcards and social media posts).
· Ontario Health (Cancer Care Ontario) helps PCPs identify people eligible for screening or follow-up through the Screening Activity Report, an online tool that gives physicians who participant in a Patient Enrolment Model practices the screening status of each of their enrolled age eligible patients (i.e., those who are overdue, never been screened or require follow up).
· Ontario Health (Cancer Care Ontario) delivers biannual webinars that are accredited for continuing professional development credits to Ontario’s Colposcopy Community of Practice, which is open to Ontario’s 400+ colposcopists. During these webinars, the program provides updates on the program and case studies on evidence-based colposcopy best practices.
· Ontario Health (Cancer Care Ontario) provided guidance in the form of tip sheets to primary care providers and colposcopists to support the screening participation in eligible populations during COVID-19.
· Ontario Health (Cancer Care Ontario) works with Regional Cancer Programs to educate primary care and colposcopy providers on cervical screening recommendations (e.g., screening summary tool, stock decks). Regional Cervical Screening and Colposcopy Leads and Regional Primary Care Leads provide expertise and education to healthcare providers in each region to support screening participation.
· To support family doctors in ensuring that their patients participate in relevant screening programs, the Ministry of Health has implemented Cumulative Preventive Care Bonuses. Through this program, eligible family doctors who practice as part of a Patient Enrolment Model, meaning, patients are formally rostered to a family doctor, may receive bonuses for maintaining specified levels of preventive care for their enrolled patients.
NB · Education (groups)
· Participant reminders
· Media (social media, radio, transit ads)
· Provider correspondence
· Bilingual program materials
· Community engagement for program feedback
· Leverage learnings from under-screened population project
· Offering virtual and in person education sessions on cancer screening programs in general, and specific to each screening site as requested by the public, health care providers, regional health authorities, community groups or special interest groups.
· Program reminder letters and re-invitation letters mailed directly to participants. Additional information about cervical cancer screening is sent with these letters.
· Coordinated communication and awareness strategies are planned regularly throughout the year to promote and increase visibility of provincial cancer screening programs via various media such as radio ads, targeted digital ads, Facebook, Twitter, billboard and transit ads, website, animated and testimonial videos)
· Program sends correspondence to primary care providers to alert them when their patients are overdue for abnormal follow up testing.
· ALL program correspondence, educational and promotional materials are offered in English and French. The program offers a toll-free phone line for public inquiries on cancer screening which is answered by bilingual staff.
· Public surveys have been offered by phone, online and following education sessions. Feedback provided to the program is collected and evaluated regularly.
· Plan to leverage the recommendations from the ongoing project ‘Developing Strategies for Underscreened Populations through Community Engagement’.
PE · Media (small and mass)
· Client reminders
· Client brochure, tracking panel card for follow up appointments
· Provider screening path
· Language – Signage cheat cards for pap clinicians
· October – Women’s Health promotion (breast, HPV, pap) Media
· Cervical Cancer Screening web site (ordering a pap appointment online, phone, fax)
· Reminder letter to clients of regional pap screening clinic, result letters including pap brochure, abnormal result letters including HPV vaccination promotion and tracking panel card
· Clinician screening tool
· Signage language card to break language barriers
NL · Education sessions provided to health care professionals, primary care practitioners and other community partners
· Partner with community partners to promote screening via social media
· Direct engagement with community health clinics and groups
· Content developed for each Regional Health Authority (RHA) and delivered via MS Teams province wide or in person. Population screening programs added to primary care practitioner orientation in some RHAs.

*Quebec does not have an organized screening program available, so there are no concerted strategies in place.