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Study: Mammography use and colorectal cancer testing

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In 2008, 72% of women aged 50 to 69 reported having had a mammogram in the previous two years, up from 40% in 1990. About 40% of Canadians aged 50 or older reported up-to-date colorectal cancer testing in 2008.

For mammography, the increase occurred in the decade between 1990 and 2000/2001, when use peaked. Rates subsequently stabilized. Before 2000/2001, mammography rates differed markedly among the provinces. Since then, provincial rates have become more similar.

The use of mammography in 2008 was less common at lower levels of income and education, and among smokers and those without a regular doctor. Mammography use declined among women in the lowest income bracket between 2005 and 2008.

For colorectal cancer, the likelihood of up-to-date testing was greater among people who lived in higher-income households, had a regular doctor, did not smoke, and were active in their leisure time. Higher percentages of seniors aged 65 or older had been tested, compared with individuals aged 50 to 64.

Differences among the provinces and territories in the percentage of people who were up-to-date with colorectal cancer testing were substantial. The percentages ranged from 28% in Quebec to 53% in Manitoba.


Organized breast screening programs were initiated in 1988, and by 1998, had been established in all provinces. In 1990, 40% of women aged 50 to 69 reported that they had had a mammogram in the previous two years; by 2008, the rate was 72%. All of the increase occurred from 1990 to 2000/2001, after which rates stabilized.

Note to readers

This release is based on the results of two research articles published today in Health Reports. They contain new information from the 2008 Canadian Community Health Survey (CCHS).

The article titled "An update on mammography use in Canada" provides information on the use of mammography by women aged 50 to 69, and reports provincial trends from 1990 to 2008. Estimates include mammograms conducted for screening or diagnostic purposes. The study also examines characteristics of women who had not had a mammogram and reasons for non-use.

The 2008 CCHS sample of 11,441 female respondents aged 50 to 69 was weighted to represent 3.8 million women in this age range.

The 2008 CCHS collected nationwide information on colorectal cancer testing for the first time. The article titled "Colorectal cancer testing in Canada" provides estimates of up-to-date colorectal cancer testing for either screening or diagnosis in Canadians aged 50 or older. The analysis sample of 30,835 CCHS respondents was weighted to represent 10.2 million people in this age group.

This study defined up-to-date colorectal testing as fecal occult blood test in the two years before the survey or endoscopy (colonoscopy or sigmoidoscopy) in the previous five years.

Organized breast screening programs have been available in all provinces and territories (except Nunavut) since 2003. Province-wide organized colorectal screening is currently available only in Ontario.

Mammography use declined among women in the lowest income households between 2005 and 2008. By 2008, 61% of women in such households had had a mammogram in the previous two years, down from 67% in 2005. A similar decrease was observed among women with less than secondary school graduation.

By contrast, since 2000/2001, the percentage of women in the highest income households who reported having had a mammogram was relatively stable, at around 78%.

Women without a regular doctor and those who had no contact with a doctor in the year before the survey were more likely to be non-users of mammography. In 2008, 71% of such women were non-users, compared with 23% of women who had a regular doctor whom they had contacted in the previous year.

About 40% of smokers reported that they had not had a mammogram in the two years prior to the survey, compared with 25% of non-smokers.

In 2008, the most common reason for not having had a mammogram, reported by 37% of non-users, was that they did not think it was necessary. A substantially higher proportion (57%) of non-users had offered this reason in 1996/1997.

Colorectal cancer testing

In 2008, the first year for which national data are available, about 40% of Canadians aged 50 or older reported that they had had up-to-date colorectal cancer testing, that is, a fecal occult blood test in the past two years, or sigmoidoscopy or colonoscopy in the past five years.

In general, the likelihood of testing was lower in provinces east of Ontario and in the territories than elsewhere, and markedly higher in Manitoba and Ontario.

In 2007, Ontario had initiated a province-wide organized colorectal cancer screening program. Manitoba launched the pilot phase of such a program in the Winnipeg and Assiniboine Regional Health Authorities the same year.

The likelihood of testing in 2008 was greatest among those who had a regular doctor whom they had consulted in the previous year. About 44% of these individuals had been tested, compared with 10% of people without a regular doctor and who had not consulted a doctor in the previous year.

A higher percentage of people who perceived their general health to be fair or poor had been tested, compared with those in better health.

Up-to-date testing for colorectal cancer was related to the presence of health risk factors. About 30% of daily smokers had been tested, compared with 42% of non-smokers. Physically inactive people were less likely to have been tested than were those who were more active.

People in lower-income households were less likely to have been tested than were those in higher-income households. About 35% of individuals in the lowest income bracket reported testing, compared with 43% of those in the highest.

Available on CANSIM: tables 105-0541 and 105-0543.

Definitions, data sources and methods: survey number 3226.

The articles, "An update on mammography use in Canada" and "Colorectal cancer testing in Canada, 2008," in today's special Health Reports online release, are now available (82-003-X, free) from the Publications module of our website.

For more information about these articles, contact Margot Shields (613-951-4177;, Health Analysis Division or Kathryn Wilkins (613-951-1769: Health Analysis Division.

For more information about Health Reports, contact Christine Wright (613-951-1765;, Health Analysis Division.