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Cervical Cancer Screening

British Columbia Specific Information

Cervical cancer is a disease in which the cells of the cervix become abnormal and start to grow uncontrollably, forming tumors. A Pap test, also known as a Papanicolaou test or pap smear, is a test used to determine if there are abnormal cells in the cervix. If abnormal cells are found, steps can be taken to try to prevent them from developing into cervical cancer. In Canada, a Pap test is the most effective and recommended screening test for cervical cancer. In B.C., it is recommended women aged 25-69 be screened every 3 years. To learn more about the cervical cancer screening program in B.C., including guidelines on who should be tested, visit BC Cancer Agency - Cervix Screening.

Approximately 70 per cent of all cervical cancer is caused by the human papillomavirus (HPV) types 16 and 18. The HPV vaccines, Cervarix® (HPV2) and Gardasil® (HPV4), protect against infection from certain types of human papillomaviruses (HPV). Health Canada approves the HPV vaccine Gardasil® (HPV4) for use in women and men. Health Canada also approves the HPV vaccine Cervarix® (HPV2) for use in women; however it is not currently approved for use in men.

Some groups are eligible to receive the vaccine for free. Those not eligible to receive the vaccine for free may purchase it from a pharmacy or doctor’s office. For information about the vaccine, including who is eligible to receive it for free, see HealthLinkBC File #101b Human Papillomavirus (HPV) Vaccine.

For more information about HPV see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts. For information on other HPV vaccine programs in B.C., visit ImmunizeBC - HPV (Human Papillomavirus).

Topic Overview

What is screening for cervical cancer?

Cervical cancer screening tests can help your doctor find and treat abnormal cell changes on your cervix before they develop into cervical cancer. These tests may be done as part of a pelvic examination.

What screening tests are used?

Tests include:

  • A Pap test. This test looks for changes in the cells of the cervix. Some kinds of cell changes can lead to cancer. Most cervical cancer screening programs use Pap tests to screen for cervical cancer.
  • A human papillomavirus (HPV) test. The HPV test looks for certain high-risk viruses that can cause cervical cancer. This test may not be available in all areas or covered by all provincial health plans.

Who should be screened?

Talk with your doctor about cervical cancer screening. Guidelines for when to start having Pap tests and how to often have them vary from province to province. Your doctor can help you find a cervical cancer screening program in your area.

If you are sexually active, it's a good idea to have regular testing for sexually transmitted infections.

How often do you need tests for cervical cancer?

  • Women younger than 25

    • If you are in this age group, routine screenings are not recommended.
  • Women 25 to 69

    • If you are in this age group, screening is recommended every 3 years.
  • Women 70 and older

    • If you are age 70 or older, and have had 3 negative Pap tests results in a row in the last 10 years, screening is no longer needed. If you haven't had regular screenings, continue getting tested until you have 3 negative test results.

What do your results mean?

The results of your Pap test may come back as normal, unclear, or abnormal. If your results are:

  • Normal, you can follow the regular schedule for your next screening.
  • Unclear, it could mean that there weren't enough cells to test or that there are small changes that aren't certain. You may be able to wait until your next scheduled screening test. Or you may need to be retested sooner.
  • Abnormal, it doesn't mean that you have cervical cancer. More likely, it means that you have changes on your cervix that will either go away on their own, or that could, over time, lead to cervical cancer. You may need an HPV test to help your doctor know which it is.

The results of your HPV test will be negative or positive. If it is positive, high-risk HPV cells were found. If your results are:

  • Negative, your doctor will let you know if you should follow the regular schedule for your next screening.
  • Positive, your doctor will let you know what comes next. Your doctor may suggest a Pap test (if you didn't have one), a follow-up HPV test, more testing (such as a colposcopy), or treatment.

References

Other Works Consulted

  • Centers for Disease Control and Prevention (2013). Cervical Cancer Screening With the HPV Test and the Pap Test in Women Ages 30 and Older. Accessed Sept. 17, 2013: http://www.cdc.gov/cancer/hpv/pdf/HPV_Testing_2012_English.pdf.
  • Sawaya GF, et al. (2015). Cervical cancer screening in average-risk women: Best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Annals of Internal Medicine, 162(12): 851–859. DOI: 10.7326/M14-2426. Accessed June 19, 2015.

Credits

Current as of:
September 8, 2021

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD - Family Medicine
Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Kirtly Jones MD - Obstetrics and Gynecology