Cancer Screening

• HPV is a family of viruses. There are more than 100 types of HPV and they can cause changes to the cells of the cervix. With some types of HPV, these cell changes can turn into cervical cancer over time if they are not treated.
• People can get HPV from having sexual contact of any kind with another person. Sexual contact includes when someone has contact with another person’s genitals (private parts). This contact can be with the hands, mouth or genitals.
• HPV is common and 8 out of 10 people will get HPV at least once in their lifetime. HPV will often go away on its own without doing any harm.
• Someone can have HPV for many years and not know it unless they get the cervical screening test.
• The cervical screening test checks for types of HPV that can sometimes cause cervical cancer. It also checks for cell changes in the cervix caused by these types of HPV. The test does not check for types of HPV that do not cause cancer.

The Ontario Cervical Screening Program recommends that most eligible people get screened every 5 years.

Get screened if you:

• are at least 25 years old
• are a woman, Two-Spirit person, transmasculine person or nonbinary person with a cervix
• have ever had sexual contact with another person
• do not have symptoms, like different bleeding or discharge [clear or yellow fluid] from the vagina [genital opening], and
• are due for cervical screening according to the Ontario Cervical Screening Program’s recommendations

Research shows that most people need cervical screening every 5 years from ages 25 to 69. Getting screened for human papillomavirus [HPV] with a cervical screening test every 5 years is as effective as getting screened with a Pap test every 3 years.

Eligible people need to get cervical screening even if they:

• have had the HPV vaccine
• feel healthy
• have been through menopause
• have not had any family members with cervical cancer
• have had sexual contact with only 1 person
• have had the same sexual partner for a long time
• have not had sexual contact in a long time
• have only had protected sexual contact
• are in a same-sex relationship
• are pregnant
• have had a subtotal hysterectomy and kept their cervix

Contact your Family Doctor or Nurse Practitioner or Family Health Team

• Mattawa Family Health Team – https://www.mattawahealth.ca/Mattawa-Family-Health-Team
• Powassan and Area Family Health Team – https://www.paafht.ca/

If you don’t have a Family Doctor or Nuse Practitioner, you can:

• Visit the GAP Clinic @ www.nipissingwellness.ca/gapclinic
• Visit the North Bay Parry Sound Health Unit Sexual Health Clinic – https://www.myhealthunit.ca/en/health-topics/sexual-health.aspx
• North East Virtual Care Clinic – https://nevirtualcare.ca/
• Ontario Health 811 – https://health811.ontario.ca/static/guest/home
• Ontario Cervical Screening Program (OCSP) – https://nbrhc.on.ca/programs-services/diagnostic-imaging-services/ocsp/

Getting screened regularly can find breast cancer earlier which may mean that:

• the chance of dying from breast cancer is lower
• treatment has a better chance of working
• fewer treatments may be needed and the treatments may be less invasive [easier to handle]

Screening can be part of taking an active role in protecting your health. Getting a normal result from a mammogram can be reassuring for some people.

Potential Harms of Regular Breast Cancer Screening

• False-positive: Getting an abnormal result when there is no cancer present. It can lead to extra testing, like a biopsy [taking a small sample of tissue], that can cause anxiety and stress for some people.
• False-negative: Missing a cancer on a screening mammogram, which could lead to delayed treatment.
• Over diagnosis: Finding a cancer that would not otherwise cause health problems, that may lead to unneeded surgery or treatment.

Your age and family medical history help determine when you should get screened:

• If you are age 40 to 49, the Ontario Breast Screening Program encourages you to talk with your family doctor, your nurse practitioner or a Health811Opens in a new window navigator to make an informed decision about whether breast cancer screening is right for you. Most people in your age group who decide to get screened for breast cancer should get screened with mammography every 2 years.
• If you are age 50 to 74, the Ontario Breast Screening Program recommends that most people in your age group get screened every 2 years with mammography.
• If you are age 30 to 69 and meet any of the following requirements, talk to your doctor or nurse practitioner about referral to the High Risk Ontario Breast Screening Program:
  • You are known to have a gene mutation that increases your risk for breast cancer [e.g., BRCA1, BRCA2, TP53, PALB2].
  • You are a first-degree relative (parent, sibling or child) of someone who has a gene mutation that increases their risk for breast cancer [e.g., BRCA1, BRCA2, TP53, PALB2].
  • You have a personal or family history of breast or ovarian cancer.
  • You have had radiation therapy to the chest to treat another cancer or condition [e.g., Hodgkin lymphoma] before age 30 and at least 8 years ago.

The Ontario Breast Screening Program offers breast cancer screening to women, Two-Spirit people, trans people and nonbinary people ages 40 to 74 if they:

• have no breast cancer symptoms
• have no personal history of breast cancer
• have not had a mastectomy
• have not had a screening mammogram within the last 11 months
• If transfeminine, have used feminizing hormones for at least 5 years in a row.

Contact your Family Doctor or Nurse Practitioner or Family Health Team

• Mattawa Family Health Team – https://www.mattawahealth.ca/Mattawa-Family-Health-Team
• Powassan and Area Family Health Team – https://www.paafht.ca/

If you don’t have a Family Doctor or Nuse Practitioner, you can:

• Visit the GAP Clinic @ www.nipissingwellness.ca/gapclinic
• North East Virtual Care Clinic – https://nevirtualcare.ca/
• Ontario Health 811 – https://health811.ontario.ca/static/guest/home
• Ontario Breast Screening Program –  https://nbrhc.on.ca/programs-services/diagnostic-imaging-services/ontario-breast-screening-program/

Benefits of regular cancer screening

• Getting screened reassures you if the result is normal.
• Cancer screening may help prevent cancer by finding changes in your body that would become cancer if left untreated.
• Cancer screening helps find cancer early before you have symptoms when it is easier to treat.
• Cancer screening helps find cancer before it spreads when it is easier to treat.
• Early detection may mean less treatment and less time spent recovering.
• The earlier a cancer is detected, the better your chance of survival.

Limitations of regular cancer screening

• Having screening tests may lead to more tests and procedures that may be harmful.
• Sometimes test results suggest you have cancer even though you don’t [called a false positive].
• The test may not detect cancer even though it is present [called a false negative].
• Some cancers would not necessarily lead to death or decreased quality of life [overdiagnosis].

Cancer screening is testing done on people who are at risk of getting cancer, but who have no symptoms and generally feel fine. Your age and family history help your doctor or nurse practitioner figure out when you should get screened for colorectal cancer and what screening test is best for you.

Your Age	Family history colorectal cancer	When to start screening	Type of screening	How often to screen
50 to 74	No parent, sibling or child diagnosed with colorectal cancer at any age [average risk]	Age 50	Fecal immunochemical test [FIT]*	Every two years
Any	Parent, sibling or child diagnosed with colorectal cancer before age 60 [increased risk]	Age 50, or 10 years earlier than the age your relative was diagnosed with colorectal cancer, whichever comes first	Colonoscopy	Every five years
Any	Parent, sibling or child diagnosed with colorectal cancer before age 60 [increased risk]	Age 50, or 10 years earlier than the age your relative was diagnosed with colorectal cancer, whichever comes first	Colonoscopy	Every 10 years

Fecal Immunochemical Test

The fecal immunochemical test [FIT] is an at-home screening test. To get your free FIT, talk with your family doctor or nurse practitioner. If you do not have a family doctor or nurse practitioner, you can get a FIT by calling Health811 at 811 [TTY: 1.866.797.0007]. 

Once a FIT has been ordered for you, LifeLabs will mail a FIT package to your Ontario mailing address of choice. For more information on how to do your FIT, see the FIT Instructions page.

If you have any problems with your FIT package, call LifeLabs at 1-833-676-1426.

Flexible Sigmoidoscopy

A flexible sigmoidoscopy is a test done by a specialist [called an “endoscopist”] at a hospital or clinic. Your doctor or nurse practitioner can send you to an endoscopist for flexible sigmoidoscopy.  

Colonoscopy

A colonoscopy is a test done by a specialist at a hospital or clinic. Your family doctor or nurse practitioner will send you for the test. If you think you may be at increased risk of getting colorectal cancer, be sure to speak with your family doctor or nurse practitioner. If you do not have a family doctor or nurse practitioner, call Health811 at 811 [TTY: 1.866.797.0007].

Potential benefits of regular lung screening

• Getting screened regularly with a low-dose CT scan can find lung cancer earlier, which may mean that:
  • the chance of dying from lung cancer is lower
  • treatment may have a better chance of working
  • fewer treatments may be required and the treatments may be less invasive [easier to handle]
• Screening can be part of taking an active role in protecting your health and can be reassuring for some people

Potential harms of regular lung screening

• Low-dose CT scans may cause false positives. Some low-dose CT scans will show a nodule that needs more testing. Usually this follow-up test is another low-dose CT scan. Most people who have more tests will not have cancer.
• Lung cancer screening may find a cancer that is growing very slowly and would never make you sick or cause you any harm. Unfortunately, it is usually not possible to tell which cancers are more harmful.

If you qualify to get screened, Ontario Lung Screening Program locations can support you in making a decision about whether screening is right for you.

People who are at high risk of getting lung cancer and qualify to get screened will be offered a type of computed tomography [CT] scan that uses a small amount of radiation. This test is called a low-dose CT scan.

During the scan, the screening participant lies on an open table that passes through a large donut-shaped machine called a scanner. The scanner uses a small amount of radiation to take detailed pictures of the lungs. The test only takes a few minutes and is not painful. There are no medications or needles given during the test.

Referral Criteria

If you are referring someone age 55 to 80, they must:

• have a smoking history of any amount of cigarettes daily for 20 years
• have Ontario Health Insurance Plan [OHIP] coverage

If you are referring someone age 81 or older, they must:

• have a smoking history of any amount of cigarettes daily for 20 years
• have Ontario Health Insurance Plan [OHIP] coverage
• have discussed risk and benefits of lung screening with you
• be well enough to undergo and recover from lung cancer treatment
• have a lifespan [over 5 years] to benefit from treatment

A referral is required from a healthcare provider for each routine low-dose CT scan (every year) for people over age 80.

Who is Not Eligible

Not everyone who meets the referral criteria will be eligible for lung cancer screening in the program.

Someone is not eligible to participate in the Ontario Lung Screening Program if they:

• have been diagnosed with lung cancer
• are actively under surveillance for lung nodules
• have had hemoptysis of unknown cause or unexplained weight loss of more than 5 kilograms [11 pounds] in the past year
• are undergoing diagnostic assessment, treatment or surveillance for life-threatening conditions [such as a cancer with a poor prognosis]

Screening is not appropriate for people with suspected lung cancer. If someone has the following lung cancer symptoms, follow the Program in Evidence-Based Care guidelines for referral of suspected lung cancer and our lung cancer diagnosis pathway:

• Hemoptysis [single episode]
• New finger clubbing
• Suspicious lymphadenopathy [such as cervical, supraclavicular]
• Dysphagia
• Features of metastatic lung cancer [such as weight loss over 5 kilograms, focal skeletal pain, headaches]
• Features suggestive of paraneoplastic syndromes

Contact your Family Doctor or Nurse Practitioner o Family Health Team

• Mattawa Family Health Team – https://www.mattawahealth.ca/Mattawa-Family-Health-Team
• Powassan and Area Family Health Team – https://www.paafht.ca/

If you don’t have a Family Doctor or Nuse Practitioner, you can:

• North East Virtual Care Clinic – https://nevirtualcare.ca/
• Ontario Health 811 – https://health811.ontario.ca/static/guest/home
• Ontario Lung Screening Program 
  Health Science North [Sudbury ON]
  [705] 523-7301
  1-844-703-0164