Patients wait months for Pap test results because labs are overcrowded, understaffed.
After experiencing unusual, unexplained bleeding and two rounds of unusual Pap tests, Wendy Yen anxiously awaits her latest results.
But the 45-year-old Toronto resident learned it could take months to find out because of backlogs and processing delays at many Canadian laboratories.
Labs screen samples for a wide array of health conditions, including Pap tests used to detect early warning signs of cervical cancer — a disease that can be life-threatening, but when It is often treatable and curable if caught early.
“It’s definitely nerve-racking waiting for the results,” Yen said.
Delays in receiving Pap test results are being experienced in most parts of the country. The COVID-19 pandemic has contributed to a backlog of all types of screening tests — but multiple industry insiders told CBC News that the problem is exacerbated by ongoing long-term staffing issues in Canada’s lab sector. has spoiled.
Most labs were already understaffed before the pandemic, said Michelle Hood, CEO of the Medical Laboratory Professionals Association of Ontario, an advocacy group for the province’s laboratory workers.
Now, with more people returning to in-person medical appointments, the influx of tests to process it continues.
“All the people who might not have gone to their family doctors to get a Pap smear is a good example. They’re all coming to our labs now,” he said.
“So we don’t have adequate staff to manage the demand that’s been driven by the increase in testing over the last 24 months.”
Months of waiting for results
Dr. Anna Wolk, a Vancouver-based family physician, previously said her patients would get Pap test results back in four to six weeks.
“Now, we’re seeing Pap results come back in four to six months,” he said.
In Toronto, patients at Dr. Iris Gorfinkel’s clinic are also facing waits of at least two months. “Everything is left behind,” he said.
Two of Canada’s leading lab companies — LifeLabs and Dynacare — told CBC News via email that turnaround times for Pap tests have increased within their labs, which operate in most parts of the country.
“Many provinces and countries are also seeing an increase in conversion times,” wrote LifeLabs spokeswoman Christine Chu, who performs about 700,000 annual Pap tests in Ontario alone.
Before the COVID-19 pandemic, the turnaround time for Pap tests was 10 to 15 days, “which we’re currently working to achieve,” he continued.
The two companies — which together process more than 170 million medical laboratory tests in Canada — also blamed the delay on an ongoing shortage of health-care staff.
In particular, there is a long-term shortage of cytotechnologists—laboratory professionals trained to spot subtle changes in patient samples that may signal early-stage disease such as precancerous cells. .
Chu from LifeLabs said only 12 to 14 cytotechnologists graduate in Canada each year.
Only one training program remains in Canada.
In Canada, cytotechnologists were once trained in several schools in several provinces. In Ontario, the country is now down to one: the Mechner Institute of Education at the University Health Network.
“It’s very alarming that we are now the only academic institution in the entire country teaching cytotechnologists,” said Professor Catherine Brown of the Toronto School.
When CBC News visited a Mechner classroom in November, students were studying Pap test samples, which show healthy cells — which look the same — and early warning signs of future cervical cancer. were looking for differences between healthy cells.
Most samples are normal, Brown said. The challenge is to find those that aren’t, to ensure that patients and their physicians get the information they need to make treatment decisions.
The long wait to get results can be “terrifying,” Brown continued, even if most come back perfectly normal.
Mixed situation in the provinces
CBC News reached out to several provinces to ask how long it is taking to process Pap tests, and what steps are being taken to minimize any delays.
In emailed statements, a spokesperson for Saskatchewan said the average length of time it takes to get results from labs is “not readily available,” while a spokesperson for Quebec said the reporting period has been suspended during the pandemic. was given
Meanwhile, a spokesperson for Ontario’s Ministry of Health said the department is in “constant contact” with community labs to discuss test turnaround times, and monitor labs’ plans to return to normal service levels. doing.
Alberta, in particular, said it is “not experiencing delays,” with 95 percent of orders being reported by labs within seven days of being received, while Nova Scotia’s processing times are actually “from 2019.” have been constant or better.”
Both LifeLabs and Dynacare said they are trying to deal with backlogs at their facilities.
Among other measures, DineCare spokesman Mark Bernhardt said the company is working on ways to “accredit foreign-trained medical professionals.”
In the meantime, as both laboratories and governments figure out how to speed up sample processing, patients like Wendy Yen are stuck waiting and wondering what’s going on inside their bodies.
“It delays what the logical next steps would be,” he said.
These next steps likely include a colposcopy, a procedure used to closely examine one’s cervix, and a biopsy, in which tissue samples are taken to analyze cancer cells.
“Early detection equals less treatment,” Yen said, “and we’re not detecting anything early with lab conditions.”