Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
Cervical Cancer Screening
Definition
Also called a Papanicolaou (Pap) test, cervical cancer screening is based on the examination of cells
collected from the cervix to reveal pre–malignant (before cancer) and malignant (cancer) changes as
well as changes due to non–cancerous conditions such as inflammation from infections.
Cervical cancer screening was measured as the age–adjusted proportion of women aged 18–69 who
received at least one Pap test in three fiscal years, from 1984/85–1986/87 through to 2005/06–2007/08.
Crude rates are available in the appendix. See Glossary for tariff codes used. The denominator includes
all Manitoba female residents aged 18–69 in the three–year period. Women who have had a complete
hysterectomy surgery were excluded from both the numerator and denominator. Rates for northern and
remote areas served by nursing stations may be underestimated due to missing data.
Time Periods Percentage of women aged 18–69 over a three–year period
T1: 1984/85–1986/87 64.76
T2: 1987/88–1989/90 67.85
T3: 1990/91–1992/93 66.73
T4: 1993/94–1995/96 65.47
T5: 1996/97–1998/99 65.80
T6: 1999/00–2001/02 67.21
T7: 2002/03–2004/05 65.64
T8: 2005/06–2007/08 65.50
Key Findings: Cervical Cancer Screening
Manitoba overall rates:
• From the first time period T1 (1984/85–1986/87) to the last time period T8 (2005/06–2007/08), Pap
test rates have been relatively stable from 64.8% to 65.5% provincially.
Rates by neighbourhood income quintile over time:
Rural:
• Comparing only T1 to T8, the Pap test rate among rural women aged 18–69 remained similar in most
rural quintiles, with the exception of R1 where rates may have decreased over time. 6
6 In the case of certain indicators where fewer events or percentages occur in the lowest compared to the highest quintile (such
as in the case of Pap tests), DRRs are below 1 and DRDs are negative—the directions of differences are somewhat non–intuitive.
The “lower” the ratio below 1 (for example, 0.7 rather than 0.8), the greater the disparity (i.e., 30% compared to 20% difference). As
well, the more negative the difference (for example, –20 compared to –10), the greater the disparity. So what appears as a positive
outcome (“lower” disparity) of lower DRRs or lower DRDs on the y–axis is actually a greater disparity.
Manitoba Centre for Health Policy 131