1. Mobilizing Newcomers and Immigrants to Cancer Screening Programs Funded by Public Health Agency of Canada (PHAC) The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada (PHAC)

2. Cancer Screening Breast Cancer Screening Cervical Cancer Screening

3. Cancer starts when cells in a part of the body start to grow out of control What is Cancer? Tissue Blood vessel

4. Cancer cells can also spread (grow) into other tissues, something that normal cells cannot do What is Cancer? Tissue Blood vessel

5.  There is no single cause for cancer  Most cancers are caused by many risk factors  Good news: we can reduce the risk of cancer What Causes Cancer?

6.  A cancer risk factor is something that increases your chance of getting cancer  There are some risk factors that we cannot change  There are some risk factors that we can change  Most breast cancer risk factors are things that we cannot change! Cancer Risk Factors

9.  Regular medical tests  Can find cancer early  Can prevent some cancers Cancer Screening Tests

10. Breast Cancer Screening

11. What is the Breast?

12.  Being a woman  Age  Family history  Having breast cancer in the past  Ovarian cancer Breast Cancer Risk Factors You Cannot Change

13. Breast Cancer Risk Factors You Can Change  Be physically active  Eat a healthy diet  Do not smoke  Avoid second-hand smoke  Limit or avoid alcohol

14. Breast Cancer Risk Factors You Can Change  Limit how long you use hormone replacement therapy (HRT) after menopause. Speak to your doctor  Get screened

15. What is the Test for Breast Cancer Screening? Mammogram

16.  Estimated new cases: 9300  Estimated deaths: 1950 Breast Cancer in Ontario 2013 Regular mammograms can find breast cancer early when it is easier to treat

17.  Women age 50 – 74 years  No changes in breast health  No personal history of breast cancer  No current breast implants  Ontario resident more than 6 months Who Can Go to Ontario Breast Screening Program (OBSP)?

18. Ontario Breast Cancer Screening Program Benefits  A referral is not needed from a doctor  You can call and book your own appointment  No cost  Result letter is mailed to your home  Reminder letter to return every 2 years

19. What Happens Before?

20. What Happens at OBSP? Change into a gown Two-view mammogram (x-ray) of each breast

21. Why is Pressure Needed?

22. What Happens After?

23. Result letter within two weeks Reminder letter for next appointment

24.  Most abnormal mammograms are not cancer  More tests (repeat mammogram, ultrasound) Abnormal Mammogram?

25.  If you have a family or medical history that puts you at high risk for breast cancer, you may need specialized screening at the Ontario Breast Screening Program  Talk to a Doctor or Nurse Practitioner Women Age 30-69 Years Who Are at High Risk

26. Be Breast Aware All women of all ages:  Know what is normal for you  Know what changes to look for  Look and feel for changes often  Report any unusual changes to a doctor or nurse practitioner immediately

27. Women Age 50 or Older…  Go for regular mammograms at OBSP  Every 2 years  You can book your own appointment  You do not need a medical referral  No cost  Breast self-exam does not replace a mammogram

28. Call this number to book your appointment: Ontario Breast Screening Program Provincial Toll-Free Number 1-800-668-9304 Where to Go for a Mammogram

29. OBSP Locations in London  London CML Healthcare Inc. – London 279 Wharncliffe Rd. N, Suite 111 London, ON N6H 2C2 (519) 661-0275  London X-Ray Associates – Bradley 105-595 Bradley Avenue London, ON N6E 3Z8 (519) 672-7900

30. OBSP Locations in London  London X-Ray Associates – Central 104-450 Central Avenue London, ON N6B 2E8 (519) 672-7900  St. Joseph’s Health Care, London 268 Grosvenor Street London, ON N6A 4V2 (519) 646-6105

32. Cervical Cancer Screening

33. What is the Cervix?

34. What is Cervical Cancer? Pre-cancer Normal Cancer 10 – 15 years

35.  Pap test What is the Test for Cervical Cancer Screening?

36. Cervical Cancer in Ontario 2013  Estimated new cases: 610  Estimated deaths: 150 Regular Pap tests combined with the HPV vaccine can prevent cervical cancer

37.  Women age 21 – 70  Who have been sexually active  Every three years The Ontario Cervical Screening Program (OCSP)

38. What Happens During a Pap Test?

39. What Happens at a Pap Test? 2 1

40. What Happens After? Result letter within two weeks Reminder letter for next appointment

41.  More tests  Less than 10% of Pap tests have abnormal results  Few of those will be cancer Abnormal Pap Test?

42. Virus infection  Very common  Found in men and women  Can cause cancer  Transmitted skin-to-skin genital contact and/or during sexual intercourse Human Papilloma Virus (HPV)

43. HPV vaccine AApproved for women age 9 - 45 RRecommended for men age 9 - 26 AAvailable to grade 8 girls at no cost through public health school program 33 doses needed Human Papillomavirus (HPV) Prevention and HPV Vaccines: Questions and Answers. http://www.phac-aspc.gc.ca/std-mts/hpv-vph/hpv-vph-vaccine-eng.php We Can Prevent HPV Infection

44. Less than 0.05%:  Discomfort at the site of application  Redness on the site  Dizziness  Headache http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/12vol38/acs-dcc-1/index-eng.php#a4-8 Possible Side Effects of HPV Vaccine

45.  HPV vaccine prevents infection  HPV vaccine does not replace Pap tests  Pap test detects cell changes before they become cancer  Almost all cervical cancers can be prevented if cell changes are found early and treated Things to Remember…

46.  Family Doctor  Middlesex-London Health Unit  Nurse practitioner clinics Where to Go for a Pap Test

49. Questions?

50. Canadian Cancer Society Cancer Information Service  Phone Number: 1 888 939 3333  TTY: 1866 786 3934  Service offered in different languages Cancer Information

51. Cancer Care Ontario www.cancercare.on.ca/pcs/screening Canadian Cancer Society www.cancer.ca Middlesex London Health Unit www. Healthunit.com South West Regional Cancer Program www.southwestcancer.ca/ For More Information

52. Thank you