Integrated Cancer Screening Dr. Meghan Davis Regional Primary Care - - PowerPoint PPT Presentation

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Integrated Cancer Screening

• Dr. Meghan Davis

Regional Primary Care Lead HNHB LHIN Cancer Care Ontario

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Cancer Care Ontario

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Regional Medical Leads

• Dr. Andrea East
• Dr. Dustin Costescu
• Dr. Terry Minuk
• Dr. Barry Lumb
• Dr. Danny Kraftcheck
• Dr. Meghan Davis

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Informed Patient Choice

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Breast Cancer Screening

• Average risk 50-74, q 2

years, self referral

• >74 require a referral
• High risk age 30-69 –

special referral form

• confirmed BRCA carrier
• First degree relative
• >25% risk (geneticist)
• Radiation therapy to chest

> 8 years ago and when less than 30 years old

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OBSP Locations Assessment Locations

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Ontario Breast Screening Program at Chedoke

ONE OBSP PROGRAM – 2 SITES

CIBC Breast Assessment Centre

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Cervical Cancer

• In Ontario, about 610 women will be diagnosed
• 40%: regularly screened – lower grade
• 60%: under- or never-screened – higher grade
• Usually slow progression – 10 years

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2012 Cervical Screening Guidelines

• Screening Age 21 to 70

every 3 years

• Specific populations:
• LGBTQ / Pregnancy /

HPV+ / HIV

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How should I screen women following exit from Colposcopy?

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Result Follow-Up CIN 2 or 3 Annual Paps HR-HPV DNA Positive (Regardless of cytology) AnnualPaps LSIL/ASCUS, No Lesion No right answer Reasonable: Annual x 3, then triennial Biopsy Proven CIN 1 No right answer Annual Paps if HPV unknown is appropriate.

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Other Pap Abnormalities

• Absent Transformation Zone – Not an

indication for repeat testing.

• Unsatisfactory – repeat in 3 months. After 2,

refer for colposcopy.

• Endometrial Cells – Over 40 and not consistent

with period, perform or refer for endometrial sampling (increased risk of endometrial hyperplasia/cancer)

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What about HPV testing?

• Not funded and funding unlikely this year
• Still need PAP test.

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Key Takeaways

• Don’t under/over

screen

• Focus on never

and under screened

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Mobile Cancer Screening

• LHIN 4
• Digital Mammogram,

Pap test, Colorectal Screening

• Targets Under or Never

Screened Population

• Continuity of Care

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403 R H V P Q E W LINC

Beasley Crown Point Jamesville Keith Gibson/ Landsdale McQuesten Davis Creek Riverdale Rolston South Sherman Stinson

Hamilton's Neighbourhood Action Strategy Boundaries

Map prepared by:

Last modified July 2013

With support from:

Legend

Major streets Escarpment

Action Neighbourhoods boundaries have been determined by the neighbourhoods and continue to be adjusted based on resident feedback. Profiles of each of these neighbourhoods are available on the SPRC website: http://sprc.hamilton.on.ca/Reports/pdf/SPRC_Neighbourhood_Profiles_March_2012.pdf For any questions about this map, please contact Sara Mayo: smayo@sprc.hamilton.on.ca

Overlapping boundary

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Mobile Coach at Six Nations/New Credit

Six Nations Rebels Lacrosse Team Bread and Cheese Day

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Community Engagement is Key!

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Screening Activity Report

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Enrolled Patients Screening Summary

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• Downloadable in PDF and Excel formats
• The “Overall Screening Status” represents someone’s most urgent status across

the three cancer screening programs. (i.e. If a patient is red in one screening program, this status will show red – indicating that the patient requires at least one action)

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Breast: Enrolled Patients (50-74)

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• Downloadable in PDF and Excel formats

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Screening Activity Report

• PEM doctors
• Released monthly
• Need to sign up to

ONE ID to get it – do it today!

• Accuracy –
• What’s missing
• What was I missing
• How can it be used?

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Improving Screening

• Find a champion -

RN, Admin

• Sustainable office

procedures

• EMR – stay tuned !
• SAR
• Optimize patient
• ffice visits
• Focus on never and

under screened

• FOB demo

Need Help? Let me know!

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Patient Education Video: Colorectal Cancer

• Video to be posted at

www.hnhbscreenforlife.ca/davis soon

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Smoking Cessation – Every Visit

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Can We Improve Our Screening Rates?

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BREAST SCREENING 61% 63% 63% CERVICAL SCREENING 64% 65% 64% COLORECTAL SCREENING 60% 64% 66% LHIN 4 Ontario Toronto

15% 50% 35%

ONE ID & SAR Adoption Toronto

18% 45% 37%

ONE ID & SAR Adoption Hamilton

Registered; viewed previous SAR Registered; did not view previous SAR Not registered For ONE ID

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Thank you!

Contact Information:

• Dr. Meghan Davis, Hamilton

davismeghan1@gmail.com Visit: www.hnhbscreenforlife.ca/drdavis