Cervical cancer screening in Canada: 2021/2022

Strategies to improve screening for underserved populations

Six provinces have employed strategies to improve screening for various underserved populations. Most jurisdictions engage specific underserved populations in decision-making and informing strategies. Screening awareness campaigns, social media posts, and brochures are regularly used to engage underserved populations in screening. Culturally appropriate client reminders have also been implemented to better reach these populations.

Strategies to improve screening for underscreened populations*

P/T Intended audiences Strategies used Strategy co-developed with community? Description of activities to improve screening for underserved populations
AB · Low-income
· Immigrants and refugees
· Racial or ethnic minorities
· Specific cultural groups
· Non-English and non-French speakers
· Education (one on one and group)
· Client invitation and reminders
· Media (small and mass)
· Provider assessment and feedback
· Healthcare provider cultural competency training
· Development of culturally safe materials and resources
· Direct community engagement to co-design programs
All: ✓ · Been engaged in a creating health equity project^ for several years with data identified lower screening subpopulations in northeast Calgary to co-design strategies with the intent to scale and spread effective methods across Alberta
MB · Newcomers
· Individuals with low literacy
· Interpreters
· Translated resources
· Pap clinic promotion (people without PCP)
· Focus testing with primary care advisory groups, and community groups
All: ✓ · Cancer screening education module created with and for educators with low literacy
· Including information of available interpreter services and translated documents on most public facing communications
· Cancer screening education module created for new international healthcare providers
· Partnered Pap test clinic reports of 4 items of accessibility: Hoyer lift, attendants on site, height adjustable exam table and wheelchair accessibility
ON · Never and under screened populations or populations who are not attached to PCPs
· People who missed their routine cancer screening test due to COVID-19
1. Mobile screening coaches
2. Screening awareness campaign~
1. ✓
· Mobile coaches in select regions (North West, Hamilton Niagara Haldimand Brant) provide screening services to people who do not have a PCP or face barriers accessing existing screening services (due to transportation or other barriers).
· The Ontario’s Ministry of Health will be leading a public campaign to remind people about the importance of regular cancer screening in September 2021 and have provided Ontario Health (Cancer Care Ontario) with funding to develop additional strategies to support the resumption of screening.
NB · People without a primary care provider
· Specific geographic area
· Immigrants and refugees
· Program provides information on local Pap test clinics offering Pap screening to those without a PCP
· Target strategies to improve participation.
· Provide program information/education by working with Multicultural Associations.
All: ✓ · Participants can call toll free screening line or go to the GNB website to access information on available clinics offering Pap testing.
· Using GIS mapping, the program is able to identify areas of low participation in order to further assess community needs and services.
· Offer informational sessions (virtual or in person) and/or promotional materials with screening information; assess information and language needs and adapt or develop tools, when able.
PE · Immigrants and refugees
· Non-English and non-French speakers
· People without a primary care provider
· Provide regional Pap clinics – no referral needed
· Online booking requests (preferred by non-native speakers), coordinated by email
· Distribute cancer screening brochures to newcomer association
· Coordinate follow up with primary care network nurse practitioner
· Language – Signage cheat cards for Pap clinicians
NL · New Canadians
· Immigrants and refugees
· Low income
· Collaboration and education and presentations to primary care providers and community groups that work with new Canadians, immigrant, refugees and low-income populations
· Provision of programmatic educations and promotions materials

*Quebec does not have an organized screening program available so there are no concerted strategies in place.
AB: ^Current stage is funded by CPAC through the Developing Strategies for Underscreened Populations through Community Engagement grant.
ON: ~Developed in consultation with primary care providers