Commentary on "Cervical cancer screening in England: the past, present, and future": a comparison with Canada

For cervical cancer screening to be most effective, all eligible women in the population must be enrolled in an organized program. In this issue, Albrow et al describe how cervical cancer screening in England migrated from "opportunistic" in the 1960s to "organized" in the 1980s and discuss its continued evolution as new screening approaches and technologies developed. England's current National Health Services Cervical Screening Programme is the poster child for organized screening delivery. A similar model of central coordination and peripheral delivery of screening does not exist in Canada. The provision of health services is under provincial jurisdiction, and consequently each province administers its own version of a cervical cancer screening program. To date, organized screening has only been achieved in 2 of 10 provinces, and screening elsewhere is opportunistic. Screening in Canada begins at age 18-21, ends at age 69-70, and mostly occurs annually. This approach has yielded a significant reduction in cervical cancer incidence and mortality, but health service utilization costs have been high. The future should see full implementation of organized screening in all provinces, and when combined with the publicly funded human papillomavirus vaccination program of young girls begun in 2008, the result should be even better cancer control. Cancer (Cancer Cytopathol) 2012;. © 2011 American Cancer Society.