A team of Canadian clinicians has published a new set of recommendations aimed at ensuring that members of disadvantaged groups, who often have difficulty getting health care, are able to access screening for medical conditions, as well as other vital services.
The recommendations, published Monday in the Canadian Medical Association Journal, are part of a new medical guideline, a document that sets out best practices and recommendations that clinicians can follow. The guideline is designed to improve health care for people who face barriers in accessing it, including those who are Indigenous, racialized or who identify as LGBTQ, as well as those who live with disabilities or on low incomes.
The guideline is intended to address the fact that many people in those groups have disproportionately poor health outcomes, either because they don’t have primary care providers or because of discrimination and stigmatization, said Nav Persaud, the Canada Research Chair in health justice at the University of Toronto, who co-led the creation of the guideline.
“We need to move beyond bemoaning inequities in health outcomes and move toward changing what we do,” Dr. Persaud said. “When it comes to interventions like outreach for cancer screening, the data on inequities suggest we need to prioritize some people for preventive care, and care in general.”
The 16 recommendations in the guideline include providing colorectal screening starting at age 45, rather than 50, which is the current standard; encouraging self-testing for cervical cancer and HIV; and performing blood tests for tuberculosis, rather than skin tests, which require multiple visits.
Other recommendations include screening patients for heart disease, automatically enrolling people with primary care providers and screening patients for depression and poverty.
While it won’t be possible to implement all of the recommendations overnight, because some will require policy changes or funding approval from governments, Dr. Persaud said he hopes the guideline can help address some gaps in the medical system and start to improve health equity.
The new guideline calls on governments to provide new public funding for primary care, and also for tuberculosis blood tests and HPV self-tests.
The recommendations could lead to improved health outcomes for many patients, and also create new efficiencies in the health care system, Dr. Persaud said.
“There are many examples where focusing on equity can actually lead to better care for everyone,” he added.
The team that created the guideline has launched a website, www.screening.ca, that individuals can use to find out if they should speak to health care providers about prioritized screening.