Marie-Hélène Mayrand, MD, MSc, FRCSC, Departments of Oncology and Epidemiology, McGill University, Montreal, PQ.
Eduardo L. Franco, PhD, Professor of Epidemiology and Oncology, Director, Division of Cancer Epidemiology, McGill University, Montreal, PQ.
The Canadian population is growing older, and women represent an ever higher proportion among the elderly: 57% of Canadians over 65 years of age are female, and in the "over 85" age group, this proportion reaches 70%.1 We can expect that specific health care issues that pertain to this segment of the population will receive renewed attention. Understandably, there has been a special interest in identifying preventive health care measures that can effectively prevent disability or premature death in women over age 65.
With the sole exception of cervical cancer, there is no evidence that screening women for urogenital neoplasms, such as endometrial, ovarian and bladder cancers, reduces mortality from these cancers, regardless of age.2 Therefore, the focus of this article will be on reviewing the basis for practice recommendations concerning screening for cervical cancer. Although essentially preventable, cancer of the uterine cervix continues to be a significant health problem, particularly in older women. In Canada, older women have the highest incidence and mortality rates from cervical cancer when compared to younger age groups.