Not enough South Asian women in Peel get pap tests — and it could be a matter of 'life and death'

A Brampton nurse is sounding the alarm that an increasing number of South Asian women are at high risk for cervical cancer because not enough of them are getting pap smears done. 

The Papanicolaou test, also known as a pap test or pap smear, is a method to screen the cervix for any precancerous or cancerous cells that can develop and cause cervical cancer. The test can detect cell changes before an individual experiences cancer symptoms and can lead to earlier interventions. 

Despite this — and despite the city's booming population — Brampton's cervical cancer screening rate is the lowest in the Greater Toronto and Hamilton Area at 48 per cent, according to a January report from Cancer Care Ontario. 

That's well behind the provincial target of at least 80 per cent of eligible women getting a pap smear every three years. 

Testing has been declining among women between the ages of 21 and 24, per the report, dropping from 66 per cent in 2007-2009 to 39 per cent in 2019-2021.

Cancer Care Ontario says a lot of that decline was in the low income or "materially deprived" Peel region. 

Even though cervical cancer is treatable, the situation has become "a matter of life and death," said Janine Herrmann-McLeod, co-chair of Brampton Caledon Health Coalition.

"It's deadly because so few people are getting diagnosed early enough for it to be treatable," she said.

Brampton women's health advocate Donna Smith says she's witnessing the impacts of low testing in her practice — and that a lot of the overdue women at high risk that she's seeing are from the South Asian community.  

"What we see is women that come into the clinic that have lived in Canada for many, many years and they may have had their first pap test after 20 years living here, despite seeing a doctor frequently in the community," said Smith, who is also a registered nurse with the William Osler Health System.

Brampton's largest immigrant population is from India, according to the 2021 census. The average national testing rate among women in India is as low as two per cent and cervical cancer is the second leading cause of death, according to a 2023 National Library of Medicine report.

"They don't know to ask for it once they reach Canada," said Smith. 

Ontario Health runs a cervical cancer screening program under which Cancer Care Ontario sends letters to eligible people inviting them for a pap test, advising them on next steps following a test and reminding them to return for a screening. 

"The program's goal is to reduce the risk of developing or dying from cervical cancer by increasing the percentage of people with a cervix (women, transmasculine and nonbinary people) who get screened regularly and who have timely and appropriate follow-up of abnormal results," said the health agency in a statement to CBC Toronto.