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Published January 10, 2024

Cancer society, gynecologists hope for national shift in cervical cancer screening

By Nicole Ireland in Toronto

The rest of Canada should follow British Columbia's lead in its new approach to cervical cancer screening, the Canadian Cancer Society and the Society of Obstetricians and Gynaecologists of Canada said on Wednesday. 

On Tuesday, the B.C. government announced that testing for human papilloma virus, or HPV, will gradually replace Pap tests as the standard screening. HPV causes cervical cancer. 

Although Prince Edward Islandwas the first province to replace Pap tests with HPV tests in doctor's offices, B.C. is the first in Canada to offer the option of doing the HPV tests at home, starting Jan. 29.  

Women and other people with a cervix between 25 and 69 years of age in B.C. will be able to order a self-screening kit, which they will then mail back to the lab in an envelope that is included in the kit.  

The self-administered test has already been used in some B.C. communities that were part of a pilot program launched in 2021.  

Health-care providers in B.C. will transition from using Pap tests to HPV tests over the next three years by patient age group, starting with people 55 and older.  

"We've long advocated for the implementation of HPV testing as the primary test and really commend B.C. as kind of a first step towards eliminating cervical cancer within our lifetime," said Charles Aruliah, manager of advocacy for the Canadian Cancer Society in an interview on Wednesday. 

The Society of Obstetricians and Gynaecologists of Canada also wants to see the rest of the provinces and territories adopt the HPV test and provide the option of self-screening at home, said Dr. Amanda Black, the society's president. 

Both Black and Aruliah said the HPV test is a more effective screening tool for cervical cancer than the Pap test.

The Pap test identifies changes and abnormalities in cervical cells, whereas the HPV test can detect the presence of the virus before those cell changes happen, they said.  

The HPV test is also easier to administer, which makes it possible for people to do it themselves. 

"(The) advantage of the self-screen certainly is that it may be able to reach patients who otherwise couldn't access care," Black said. 

The test could be an option for people living in remote areas who can't easily get to a health-care provider, she said. 

It could also be a way to reach people who have experienced cultural or racial trauma in the health-care system and therefore avoid physical examinations or interactions with providers. 

The at-home kit is a swab that needs to be inserted a few centimetres into the vagina, then rotated for 20 to 30 seconds, Black said.  

The swab doesn't have to reach the cervix, so the chances of someone doing the test incorrectly are small, she said.  

If someone tests positive for HPV using the home test, they would then be referred to a health-care provider forfollowup, Black said. 

She emphasized that getting vaccinated against HPV is another critical prevention measure against cervical cancer. 

Other provinces besides B.C. and P.E.I. are at various stages of planning a transition from Pap tests to HPV tests, including Quebec, Ontario and Manitoba, Aruliah said.

Banner image: THE CANADIAN PRESS/Ethan Cairns

This report by The Canadian Press was first published Jan. 10, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

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