Quebec will replace Pap smears with HPV testing as the main tool for detecting cervical cancer, the Ministry of Health has announced.
The HPV test, which detects high-risk types of human papilloma virus, will be offered to women between the ages of 25 and 65 every five years.
The announcement comes a month after the regional health authority of the eastern municipalities launched pilot project allowing 400 women between the ages of 21 and 65 to detect HPV at home using a swab test.
However, a Health Ministry spokesman told CBC News that the government has no plans to offer self-testing kits at this time. For HPV screening, doctors will administer the tests to patients and analyze the results in a laboratory. Details on the screening program will be defined in the coming months.
On Tuesday, Health Minister Christian Dubé said the province’s new health plan aims to improve the patient experience, including “moving away from the typical intrusive test”.
“I think it will ease women’s desire to pass this test,” she said.
It is currently recommended that people with a sexually active cervix be tested for Pap smears every two to three years.
A direct approach
Experts have called for HPV testing to become the primary tool for screening for cervical cancer in Canada for years, citing the test security and profitability.
The Quebec Provincial Institute of Health (INESSS) recommends adopting the HPV test model from 2017.
The UK, Australia and the Netherlands have already adopted the HPV test model as the main tool for screening for cervical cancer. In January 2022, PEI also announced the change.
Unlike Pap smears, HPV tests allow doctors to check the root cause of cervical cancer, said Dr. Lucy Gilbert, director of gynecologic oncology at McGill University Health Center.
HPV is spread through any type of sexual contact and is known to cause almost all cervical cancers.
A Pap smear test requires looking at 60,000 to 300,000 cells on a slide and looking for some normal cancer cells, according to Gilbert.
“[The pap test] He has done very well, but his time has passed because there are better things, “he said.” Instead of looking at this inaccurate test … now look for the cause of this problem, which is HPV. ”
Additional tests
Quebec will not be delivering HPV test kits home soon, but the possibility of moving toward self-sampling could allow women to take care of their own health.
BC launched a cervical test at home pilot project in December 2021.
However, there are no tools in Canada that are approved for the HPV test at home at this time, said Dr. Catherine Popadiuk, a gynecologist-oncologist and president of the Canadian Foundation for Women’s Health.
He points out that Quebec will have to decide the path for patients who test positive for HPV and need additional diagnostic services for cervical health because colposcopy clinics, centers dedicated to examining the cervix for signs of disease, are a scarce resource.
“A positive HPV test doesn’t mean you have cancer or pre-cancer. It’s just that you have the virus,” he said. “To find out if you’re at risk, we’ll need a second test.”
In Canada, it is estimated that one in 168 women will develop cervical cancer in their lifetime. In 2021, of the 1,450 new cases of cervical cancer diagnosed in Canada, 290 were in Quebec.