This email provides updates on three topics:
1) Novel Coronavirus cases
2) Cervical cancer screening protocols
3) Video on low risk drinking guidelines

1) Novel Coronavirus cases:

There have been three recent cases of the novel coronavirus identified in the United Kingdom - one of whom died; another had mild illness and has recovered; and the third is still receiving treatment. The first of the three new cases had a travel history to Saudi Arabia and Pakistan. The other two cases are relatives of the first case and have no travel history. This cluster of cases indicates the potential for human-to- human transmission of the novel coronavirus. In total, there have been 12 people identified with this new virus, resulting in six deaths.

2) Cervical cancer screening protocols:

There have been recent changes in the provincial cervical cancer screening protocols. Cancer Care Ontario is now recommending that cervical cancer screening begin at 21 years of age in sexually active women. The routine screening frequency is now three years for those without abnormalities and who are not immunocompromised.

More recently the Canadian Task Force on Preventive Health Care (CTFPHC) published guidelines which largely align with Cancer Care Ontario's guidelines - with two major exceptions. The Canadian Task Force suggests screening starts at age 25 years if the woman is already sexually active, and the guidelines do not include the use of the human papillomavirus (HPV) test as this test was not reviewed by the Canadian Task Force.

Cancer Care Ontario is not planning any changes to the current guidelines as a result of the Canadian Task Force recommendations. Cancer Care Ontario recommends that primary care providers follow their current guidelines which are summarized as follows:

• Initiate screening in sexually active women at 21 years of age. Women who are not sexually active by 21 years of age should delay cervical cancer screening until the woman becomes sexually active. Regardless of sexual activity, there is no evidence to support screening women under 21 years of age.
• Screening is to be done every three years.
• Screening may be discontinued at age 70 if there is an adequate negative cytology screening history in the previous 10 years (i.e. three or more negative cytologic tests).

Recommended transitioning to primary screening with the human papillomavirus (HPV) test for women aged 30 to 65 years every five years, within an organized screening program.

Cancer Care Ontario will continue to monitor the evidence as to when women should initiate screening for cervical cancer and plans to re-evaluate the optimal screening age when its guidelines are updated in 2014/2015.

Note that changes in Pap smear screening frequencies should not alter screening for sexually transmitted infections, which should be conducted based on the woman’s history of risk.

Please continue to promote the free human papillomavirus vaccine to eligible women as outlined in this email from September 2012.

3) Video on low risk drinking guidelines:

The Health Unit has produced this very cool video to help explain Canada’s low risk drinking guidelines. This video is a great resource to direct patients to for more information about alcohol. 

As a reminder, the College of Family Physicians of Canada launched a very useful tool to help physicians with the screening, brief intervention and referral of patients regarding their alcohol use.

Additional information on Canada’s low risk drinking guidelines can be found at CCSA.ca.

Bryna