Academic journal article Canadian Journal of Public Health

A Review of a Prison Cervical Cancer Screening Program in British Columbia

Academic journal article Canadian Journal of Public Health

A Review of a Prison Cervical Cancer Screening Program in British Columbia

Article excerpt

ABSTRACT

Objective: To review a 1995 Pap smear screening program at Burnaby Correctional Centre for Women (BCCW).

Method: 129 inmates (15%), were screened in BCCW in 1995. General population data were obtained from the British Columbia Cervical Cytology Screening Program (BC CCSP) Registry.

Results: BCCW inmates aged 25-29 years were 1 times more likely to have high grade cytologic abnormalities on Pap smear screening compared with age-matched general population (p

Conclusions: Prison inmates presented with more severe abnormalities on Pap smear screening at a younger age, and had received Pap smear screening less frequently, compared with the general population.

ABREGE

Objectif: passer en revue un programme de depistage par frottis mene en 1995 au Centre correctionnel pour les femmes de Burnaby.

Methode: 129 detenues (15%) ont en un depistage par frottis au Centre correctionnel en 1995. Les donnees demographiques generales one ete depistage de la cytologie cervicale de la Colombie- Brittannique Resultats- les detenues du Centre correctionnel agees de 25 a 29 ans avaient onze fois plus de chance de presenter des anpmalies cytologiques graves lors du frottis que la population generale du meme age (p< 10^sup -10^). Dans la categorie des 20 a 34 ans, 47% des detenues avaient eu au moins un frottisw et l'ethnicite des deenues duCentre correctionnel (p=0.85).

Conclusions: en comparison avec la population generale, un plous grand nombre d'anomlaies graves ont ete depistees par frottis chez depistages par frottis sont moins frequents chez les detenues.

Known risk factors for cervical cancer include early age at first intercourse or first pregnancy, multiple sexual partners, exposure to human papilloma virus, cigarette smoking, immunosuppression of any cause including HIV infection and prior or concomitant neoplasia of the vulva or vagina.l-3 In addition, the risk of death from invasive cervical cancer is highest in women who have not participated in Pap smear screening programs or in women in whom the interval between Pap smears is long.4 Current Canadian recommendations for Pap smear screening stipulate that all women age 18 and over, or after first sexual intercourse, be screened annually for the first two years and if these smears are negative, the women should be rescreened every three years (two years in BC) to age 69.?5

Previous studies have reported an increased rate of cervical intraepithelial neoplasia and invasive cervical cancer in female prison inmates compared with the general population in the same area.6-9 The Burnaby Correctional Centre for Women (BCCW) is the only prison in British Columbia for adult female offenders. In January 1995, a Pap smear screening program was introduced at BCCW. The purpose of this paper is to document the results of this program, to compare these results with those of the general population, and to compare characteristics of those BCCW individuals who did, and those who did not, receive a Pap smear in BCCW in 1995.

MATERIALS AND METHODS

All inmates in BCCW at any time in 1995 were asked, by way of a form circulated by the nurses (Figure I), if they would like to have a Pap smear. Those who accepted were booked for an evening Pap clinic with a female physician. Pap smears were also performed during regular physicians' clinics if required as part of a gynecological assessment (Figure 2). All Pap smears were processed and read at the British Columbia Cancer Agency (BCCA) cytology laboratory. Individuals warranting colposcopy were referred to the Women's Clinic at Vancouver Hospital and Health Sciences Centre.

The 1995 BCCW Pap smear results were compared with 1995 Pap smear results of the general population using data from the BC CCSP Registry. …

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