Health screening

22 November 2011

Guidelines on Cervical Cancer Screening in Québec

Population targeted by the screening

All women who are sexually active or were in the past.

Sexual activities include all types of genital contact, with or without vaginal penetration, with male or female partners.

At what age should screening begin?

The recommended age to begin screening is 21.

However, screening can be delayed for women who have not yet had sexual activity at this age. Exceptionally and based on the clinical context, screening may begin earlier, for example, among immunodepressed young women.

How often should one have a screening test?

The recommended interval between screening tests is two to three years.

At what age should screening be stopped?

Among women who have had screening tests regularly, screening may cease at the age of 65 if the results of the last two tests conducted in the previous 10 years were neg…

Groupe de travail sur les lignes directrices pour le dépistage du cancer du col utérin au Québec
25 March 2011

Reference framework for screening and medical surveillance in occupational health: Summary

By its very nature, screening is characterised by administering a test to presymptomatic or early symptomatic individuals who may benefit from a more effective intervention if it is performed before the usual time of diagnosis.

Far from being a trivial intervention, screening can lead to significant consequences to the people screened. Therefore, before offering screening to workers, its effectiveness and the predominance of benefits over disadvantages must be demonstrated at the population level. Furthermore, screening should have the recommended characteristics in order that the expected benefits can be observed in practice.

Approaches using algorithms or flowcharts are generally meant to be sequential. Our approach had to be flexible and allow for compromises. The proposed approach involves three key decision-making nodes, which must generally be addressed in a sequential manner. Generally speaking, a satisfactory response to one of them is required before moving…

Comité d'experts sur le dépistage et la surveillance médicale en santé au travail
1 June 2009

Suitability and feasibility of a colorectal cancer screening program in Québec: Executive summary and conclusions of the report of the scientific committee established by the Institut national de santé publique du Québec

Randomized comparative trials have shown that screening can reduce the mortality from colorectal cancer. However, due to difficulties of implementation, as observed in various countries, the expected benefits might not be achieved. The Committee recommends that the following conditions be met prior to implementing a provincial program:

Accessibility to colonoscopic examinations should be governed by the implementation of clinical, quality and performance standards that will be applied to all clienteles in all services offering this examination in Québec.

Individuals with a high risk of colorectal cancer, primarily those identified by a family history of colorectal cancer, should be so informed, and they should have access to screening that corresponds to their specific risk.

A demonstration project to show the feasibility of a program targeting average-risk individuals should be carried out before implementing a program at the provincial level.

The ef…

1 May 2009

Recommendations on optimizing cervical cancer screening in Québec

In 2007, the Comité sur l'immunisation du Québec (CIQ) recommended the establishment of a human papillomavirus (HPV) immunization program with the main objective of reducing the incidence of cervical cancer. In its recommendation paper, the CIQ pointed out the importance of measuring the impact of such a program and the necessary complementarity that should exist between the immunization program and cancer screening activities. However, it was not within the organization's mandate to issue specific recommendations regarding screening.

The present recommendation paper is an extension of the CIQ's recommendations. Its objectives are to clarify the relevance of cervical cancer screening now that vaccination is on its way, to document the current weaknesses in screening, and most of all, to identify the conditions, strategies and means to maximize the effectiveness and efficiency of cervical cancer screening in Québec.

The analysis of current screening weaknesses was bas…

12 June 2008

Evaluation of the performance of designated screening centers of the Programme québécois de dépistage du cancer du sein (PQDCS): description of the methods

The evaluation of the Programme québécois de dépistage du cancer du sein (PQDCS) is based primarily on the analysis of performance indicators as defined in the PQDCS guidelines. Methods were initially developed to measure performance indicators at the provincial level and then in individual regions. The goal of this report is to develop an approach for the measurement and comparison of performance indicators at the screening centre level.

The indicators selected to evaluate the performance of individual centres are: the detection rate, recall rate, and number of false positives per screen detected cancer. These indicators are estimated separately for initial and subsequent screens. The percentage of in situ cancers, the percentage of small invasive cancers, and the percentage of lymph nodenegative invasive cancers were also selected. To evaluate a centre's performance, these indicator measurements were compared to the measurements for Quebec as a whole, as well as w…

Équipe d'évaluation du PQDCS
7 November 2005

Interval cancer in women following a normal initial mammogram in the Québec Breast Cancer Screening Program in 1998-2000

Interval cancers are cancers that are diagnosed during the interval between a negative screen and the subsequent screen. The rate of interval cancers is a performance indicator in the terms of reference of the Quebec Breast Cancer Screening Program (PQDCS). The PQDCS terms of reference do not set a standard for interval cancer rates, but the Evaluation Indicators Working Group, which monitors breast cancer screening programs in Canada, has determined that the rate of interval cancers should not exceed 6 cases of invasive cancer per 10,000 person-years within 12 months of a negative screen, or 12 cases per 10,000 person-years within 24 months of a negative screen.

The primary objective of this analysis was to estimate the rate of interval cancers among women who received an initial mammography in the PQDCS in 1998-2000 and whose mammogram was interpreted as normal (including non-equivocal benign lesions). The analysis also sought to identify the characteristics of women, radi…

Équipe d'évaluation du PQDCS
1 May 2003

North American Conference on deafness screening and intervention in early childhood - Abstracts and PowerPoints

Here are the abstracts and PowerPoints of the North American Conference on deafness screening and intervention in early childhood (January 23-25, 2003).