Updated Cervical Screening in BC

As many of you know, BC's cervical cancer screening program underwent a big shift beginning January 2024 and understandably there have been many questions.

Under the previous program, cervical screening with a PAP exam was recommended every 3 years for people with a cervix and normal risk, between the ages of 25-69. This test looks for abnormal cells on the cervix. It is not a perfect test.

Some of the challenges include: 

• Lack of access to testing.
• Inadequate swabs - samples need to include cells from the cervical transformation zone which is often missed, and also harder to locate in post-menopausal women.
• System overwhelm - it has been taking 4-6 months or more for PAP results to come back, over the last few years.

The new program is pivoting to HPV testing as the initial step in the screening process. An HPV Self-testing Kit can be ordered online or by phone, enabling an at-home sample collection. This self-collected sample is sent to BC Cancer Agency for analysis.

Accessibility should be better for those in remote areas, without a family doctor or facing barriers like pain, trauma or mobility issues preventing screening.

Why are things changing?
Human Papillomavirus (HPV) is a virus that is transmitted through sexual contact and has widespread prevalence, an estimated 70% of Canadians will experience an HPV infection in their lifetime. High-risk strains of HPV cause 99% of cervical cancers. This new screening guideline tests for the presence of HPV first, allowing triaging based on results.

Self-screening outcomes lead to 3 possible paths:
1. Normal Results - Repeat self-screen every 5 years.
2. HPV Present (Non High-Risk Strains) - Referral for an in-clinic PAP exam.
3. HPV High-Risk Strains (HPV 18 or 18) Present - Direct colposcopy referral potentially followed by biopsy.

The new process speeds up response times for higher risk people, while reducing over treatment of low-risk individuals. 

All screening programs target asymptomatic individuals. If you are experiencing symptoms such as pain or bleeding with intercourse, bleeding between periods, irregular vaginal discharge, or symptoms of genitourinary syndrome of menopause, an in-person examination is indicated. We definitely do not want this change to mean less support for people with vaginas!

It is still possible to request a standard PAP exam if that is your preference.

To order a HPV testing kit if you are eligible: 

• online: screeningbc.ca/cervix 
• phone: 1-877-702-6566

The kit will arrive by mail in a plain, unmarked package with instructions for submitting upon completion of the swab.