1. Research Partnerships
Disparities in cervical cancer screening are known to exist in Ontario, Canada for foreign-born women. The relative importance of various barriers to screening may vary across ethnic groups. This study aimed to determine how a woman’s region of origin affected her likelihood of cervical cancer screening.
Using OHIP billing codes, this study determined the proportion of women who were not screened during the three-year period of 2006-2008 among 455 864 identified immigrant women living in Ontario’s urban centres. Certain variables were significantly associated with lack of screening, no matter where in the world immigrant women came from.
These variables were: being younger than 34 or older than 50, living in the lowest-income neighborhoods, not having a family doctor, having a family doctor who was from the same part of the world, and having a male family doctor.
To increase screening rates across immigrant groups, efforts should be made to ensure that women have access to a regular source of primary care, and ideally access to a female health professional. Low rates of cervical cancer screening among urban immigrants: a population-based study in Ontario, Canada Lofters A, Moineddin R, Hwang S, Glazier R. Med Care. 2010; 48(7):611-8. The objective of this study was to examine rates of appropriate cervical cancer screening among women living in Ontario, Canada.
This study included 2,273,995 screening-eligible women aged 25 to 69 years, who resided in Ontario’s metropolitan areas during the calendar years 2003, 2004, and 2005. OHIP billing data was used to determine which women had undergone cervical cancer screening with a Pap test during the three year period. Appropriate cervical cancer screening occurred for 61.1% of women.
Screening rates were especially low among: women aged 50 to 69 years; women living in low-income areas; and recent immigrants. Women with all three of these characteristics had a screening rate of 31.0% compared with 70.5% among women with none of these characteristics.
Within a system of universal health insurance, appropriate cervical cancer screening is significantly lower among women who are older, living in low-income areas, or recent immigrants. Efforts to reduce disparities in cervical cancer screening should focus on women with these characteristics.
2.Medical & Scientific Advisors for Accuracy
Dr. Juliet Daniel
Dr. Juliet Daniel is a Professor in the Department of Biology at McMaster University. Dr. Daniel received her B.Sc. from Queen’s University (Kingston), her Ph.D. from UBC (Vancouver), and completed postdoctoral fellowships at St. Jude Children’s Research Hospital and Vanderbilt University in Tennessee. At McMaster, Dr. Daniel’s research team focuses on understanding how disruptions in cell-cell adhesion and signaling through transcription factors contributes to breast cancer initiation and progression.
Dr. Daniel is most interested in the aggressive triple negative breast cancer subtype, TNBC, which is associated with poor prognosis due to an absence of specific therapies. Intriguingly, young pre menopausal women of African ancestry have a higher TNBC prevalence and mortality compared to other ethnicities despite a lower incidence and lifetime risk of breast cancer. Since socio-economic status does not fully explain the racial disparity in TNBC prevalence and mortality, Dr. Daniel seeks to identify unique biomarkers or gene mutations that may explain this racial disparity.
Her team will utilize genetic, genomic, molecular and cell biology techniques to analyze TNBC tissues from populations of shared African ancestry (Caribbean and West Africa) to identify genetic risk factors that can be used as biomarkers to diagnose or develop therapies for TNBC patients worldwide.
Dr. Aisha Lofters
In addition to her position at DLSPH, Dr. Lofters is a family physician with the St. Michael’s Hospital Academic Family Health Team and a scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital. She is an assistant professor at the University of Toronto in the Department of Family and Community Medicine and an adjunct scientist at the Institute for Clinical Evaluative Sciences.
She currently holds a Career Development Award in Prevention from the Canadian Cancer Society Research Institute. Her research interests include cancer screening, immigrant health, and health equity, using a broad range of methods including secondary database analysis and community-based participatory research.
Dr. Onye Nnorom
Dr. Onye Nnorom is a Family Doctor and a Public Health & Preventive Medicine specialist. She practices at TAIBU Community Health Centre, in Scarborough and is the Primary Care Lead for the Central East Regional Cancer Program (Cancer Care Ontario), providing leadership on matters of cancer prevention and care to primary care physicians in the region.
She is also the Associate Program Director of the Public Health & Preventive Medicine Residency Program at the University of Toronto and holds a cross-appointment in the Department of Family and Community Medicine.
Dr. Nnorom completed her medical degree at McGill University and then completed a Masters of Public Health (Epidemiology) and residency training at the University of Toronto. Being of Nigerian and Trinidadian heritage, she is particularly interested in immigrant health, and Black community health and wellness. Her main area of interest is in the prevention of chronic diseases, particularly cancer.